These lesions often have an exophytic growth and are indistinguishable from renal cell carcinoma

on computed tomography scan. The management of EAML is surgical resection given its malignant potential, which can only be ascertained by a thorough pathologic examination. There is no clearly identified role for neoadjuvant, adjuvant, or primary chemotherapy or targeted therapies. Nephron-sparing surgery should be attempted as these patients are at increased risk for both benign and malignant Caspase inhibitor pathologies, which may require procedures that exacerbate renal function. Because the natural course of this rare neoplasm is not predictable, these patients should undergo surveillance for recurrence or development of new lesions. Of the 33 patients with follow-up data reported by Nese et al,5 5 patients recurred with a mean time to recurrence of 32 months (range, 8-72 months). There are no guidelines on the imaging modality or frequency for surveillance. EAML is a rare variant of AML that can mimic renal cell carcinoma in its radiographic appearance. Histologically, EAML can be diagnosed by Human Melanoma Black-45 staining and the presence of dysmorphic vasculature, epithelioid smooth muscle, and adipocytic tissue. Treatment is often

surgical excision as current literature suggests the potential for malignancy. “
“Supernumerary

kidney is an extremely rare abnormality, and to our knowledge there is only 1 case reporting it along with a horseshoe see more kidney.1 The true incidence of this anomaly cannot be calculated because of its infrequent occurrence. We report a case of supernumerary kidney consisting of 4 renal moieties and including a horseshoe kidney. A 40-year-old CYTH4 woman presented with intermittent vague abdominal pain and heaviness. She could not remember the exact time of onset of her symptoms but explained that she had visited physicians a few times for this problem over the last few years. Her genitourinary history was also significant for a spontaneous stone passage that had occurred 3 years ago. Her physical examination did not reveal any significant finding. Hematologic and biochemical investigations were within normal limits. Ultrasonography of the urinary tract revealed 2 kidneys on the left side and horseshoe kidneys located distal to them. The right horseshoe kidney was small in size. She underwent further imaging evaluation with computed tomography and excretory urography, which showed the following findings: on the left, there are 3 kidneys. The inferior pole of the most rostral kidney (110 mm × 44 mm) is fused to the upper pole of another moiety (80 mm × 44 mm; Figure 1 and Figure 2).