Presentation
Abdominal swelling, vomiting and dyspepsia
Patient Data
Scout image reveals scanty of gas at the right side of the abdomen. CT images reveal a large irregular shaped heterogeneous mass related to the inferior pole of the right kidney with posterior rounded hemorrhagic component (bleeding in preexisting renal cyst). The mass extends anteriorly compressing and displacing the ascending colon with no line of separation in-between and displaces the adjacent bowel to the left side. There is compression on the right ureter and back pressure changes on the right kidney.
Diagnosis: Exophytic adenocarcinoma of the ascending colon (pathology proven)
The red arrows refer to the ascending colon inseparable from the mass.
Case Discussion
Provisional diagnosis was renal cell carcinoma before the pathology made it clear. Large abdominal mass may induce difficulties spotting its original location.
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