There is a large lobulated heterogenous non-calcified soft tissue mass in the left kidney. The mass measures approximately 9.2 x 7.4 x 10.2 cm (AP x T x L). It shows arterial vascular supply. There are areas of non-enhancement suggestive of necrosis or cystic components. There is no extension of the mass behind the aorta. The upper portion of the mass reaches the midline. The left ureter is displaced medially but shows no wall thickening or filling defect.
The adjacent bowel loops are displaced. The pancreatic tail is effaced and also displaced towards the right. The mass abuts and partially effaces the adjacent psoas muscle.
The left renal vein and suprarenal inferior vena cava are expanded with a filling defect indicative of tumour thrombosis. Filling defects, likely thrombi, are also seen in the infrarenal inferior vena cava and bilateral iliac arteries.
A round non-enhancing hypodensity, likely a cyst measuring 1.9 x 1.0 cm (AP x T), is seen in the right kidney. The right ureter is unremarkable.