%0 Journal Article %A José Iván Robles-Torres %A José Gustavo Arrambide-Herrera %A Max Molina-Ayala %A Sergio Alan Dávila-Martínez %A Pedro Antonio Madero-Morales %A Lauro Salvador Gómez-Guerra %T Collision Tumor of the Kidney: Renal Cell Carcinoma Hidden in a Giant Angiomyolipoma in a Patient With Tuberous Sclerosis Complex %D 2021 %R 10.31486/toj.20.0075 %J Ochsner Journal %X Background: A renal angiomyolipoma is a mixed mesenchymal benign tumor composed of smooth muscle, adipose tissue, and blood vessels. Malignant transformation of angiomyolipomas is anecdotal. To our knowledge, only 6 cases have been reported, and 4 of the patients had tuberous sclerosis complex diagnosed.Case Report: We present the case of a 29-year-old male with tuberous sclerosis complex who arrived at the emergency room with gross hematuria and a painful right-sided abdominal mass. Imaging studies revealed active bleeding from a giant angiomyolipoma. An emergency nephrectomy was performed. Histopathology evaluation revealed an angiomyolipoma with a focal lesion and clear cell renal carcinoma within the tumor.Conclusion: Limited evidence is available to dictate management of collision tumors of the kidney in the scenario of tuberous sclerosis complex, so a multidisciplinary approach that includes urology, oncology, genetics, and nephrology intervention needs to be considered. No standardized follow-up modality has been established for angiomyolipomas, so patients should be placed under active surveillance, similar to that carried out in cases of renal cell carcinoma. %U https://www.ochsnerjournal.org/content/ochjnl/early/2021/04/20/toj.20.0075.full.pdf