A large mass is seen infiltrating most of the upper and mid portions of the left kidney, centered on upper part and posterior cortex, leaving only the anterior cortex stretched around the lesion and lower pole. The lesion is avidly enhancing in the arterial phase with rapid washout in subsequent phases. It shows extensive central necrosis and forward displacement of the kidney. There is no associated lymphadenopathy or renal/IVC vein invasion, however there are tortuous veins surrounding the mass, likely the venous drainage. No suprarenal invasion or distant metastasis.