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Clear cell renal cell carcinoma

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Screening abdominal US identified an inhomogenous mass in the upper pole of the left kidney.

Patient Data

Age: 55 years
Gender: Male

There is a heterogenous, avidly enhancing mass in the upper pole of the left kidney. The tumor is almost reaching, but not breaking through the perirenal fascia. Some slightly larger lymph nodes are visible medial to the kidney. A tumor thrombus is seen advancing in the left renal vein, that is best appreciated in the arterial phase scan in the coronal plane. 

Case Discussion

Imaging findings are in line with renal cell cancer with renal vein involvement.

A radical nephrectomy and adrenalectomy, and regional lymphadenectomy was performed. The final histopathological diagnosis was clear cell renal cell cancer with a Fuhrman grade varying between 1-4. No sign of adrenal gland or lymph node involvement was identified (pT3a, N0). 

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