Presentation
Work up for hematuria.
Patient Data
A 70× 55 mm well-defined partially exophytic hetero-enhancing mass is noted in the lower pole of the right kidney that bulges into the urinary collecting system. There is no sign of local invasion, vascular extension, or regional lymphadenopathy.
The gallbladder is distended up to 55 mm with normal wall thickening and without CT-detectable stone or mass.
A 22 mm cyst-like lesion is noted at the lower pole of the spleen.
Case Discussion
The patient underwent a right nephrectomy, and histopathology findings confirmed renal cell carcinoma, clear cell type (Fuhrman nuclear grade 2, acinar growth pattern).
Clear cell renal carcinoma is the most common type of renal cell carcinoma. On imaging, compared to other forms of renal cell carcinoma, it is said to have an exophytic appearance and a greater degree of enhancement on the corticomedullary and nephrographic phases on multiphasic CT, with a more heterogeneous appearance 1.