eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-12-09 10 1 10 12 10.12691/ajmcr-10-1-4 AJMCR20221014 article Mazaher Ramezani mazaher_ramezani@yahoo.com 1 2 Farhad Kavousi 2 Soha Zia 2 Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Angiomyolipomas (AMLs) are the most common benign tumors of kidneys. Due to the presence of challenges in radiology in some cases, a biopsy is needed for differentiation between benign and malignant tumors and to avoid unnecessary treatment. The patient was a 53-year-old female who presented with a right renal cyst and left flank fullness. The history of the renal cyst was 20 years ago. Ultrasound examination showed a solid-cystic hypervascular mass in favor of cystic renal cell carcinoma or multilocular cystic nephroma. After surgery, the pathologist reported angiomyolipoma with extension to the capsule and tumor greatest diameter of 15cm. Physicians must be aware of this entity, different presentations, radiology, and histopathology aspects, to avoid misdiagnosis and unnecessary treatment. http://pubs.sciepub.com/ajmcr/10/1/4/ajmcr-10-1-4.pdf Angiomyolipoma case report kidney neoplasms cystic degeneration