Very large mass along the anterior aspect of the left kidney measuring 9.3 x 7.6 x 8.3 cm (AP x TR x CC). It appears to be arising from the medial anterior cortex, with loss of distinct tissue plane (best seen on the sagittal reformats). Mild hydronephrosis of the left kidney which is likely due to mass effect, as the left ureter is compressed as it courses around the mass.
Lower attenuation projection medially from the mass measuring 1.6 x 1.4 cm (series S6 image #70). The mass has a mildly thickened and enhancing wall. Internally, there is heterogeneous areas of higher and lower attenuation. There is an attenuation difference on pre and postcontrast imaging of approximately 15-20 Hounsfield units in several locations, suggesting possible but equivocal enhancement. Mildly prominent adjacent periaortic lymph node, indeterminate.