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There is a large left-sided necrotic renal mass with few foci of calcification. The mass demonstrates heterogeneous enhancement in the post-contrast study and it extends beyond the gerota's facia(notice the mass waisting) with an invasion of the adjacent mesentery and bowel loops.
Splenomegaly and multiple enlarged necrotic lymph nodes also noticed. Chest CT scan reveal enlarged mediastinal lymph nodes and multiple cavitory masses consistent with metastasis.