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Renal cell carcinoma

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Hematuria and left flank pain.

Patient Data

Age: 80 years
Gender: Female
ct

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.

Case Discussion

The patient underwent total nephrectomy and pathology revealed clear cell carcinoma. Staging made by CT was T2b N0 M0. Avidly enhancing renal masses include clear cell carcinoma and oncocytoma while chromophobe and papillary carcinoma are less enhancing.

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