Left renal carcinoma (T3a) with varicocele

Case contributed by Dr Ian Bickle

Presentation

LIF pain and frank hematuria. Urinary frequency over last month. Urine dip - blood only

Patient Data

Age: 70 years
Gender: Male

9.6cm left lower pole renal mass consistent. The mass invades the renal hilum and the renal pelvis with associated hydronephrosis.

The renal vein is expanded by tumor occluding the origin or the left testicular vein with a resultant left testicular varicocele.

Simple right renal cyst.

No significant infra diaphragmatic lymphadenopathy. Normal adrenals. No metastases.

Case Discussion

This is a T3a renal cell carcinoma due to its extension into the left renal vein.

The interesting aspect of this case is the tumor extension into the vein has caused occlusion of the left testicular vein with a resultant varicocele.  The traditional teaching on identifying a left sided varicocele has been to examine for a renal tumor.  A fellowship classic for MRCP or FRCS.

Here, you have a radiological example to prove it.

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Case information

rID: 82578
Published: 6th Oct 2020
Last edited: 8th Oct 2020
System: Urogenital
Inclusion in quiz mode: Included