Massive renal cell carcinoma with tumor thrombus, also unicentric Castleman disease
Presentation
Night sweats, weight loss.
Patient Data
Bilateral pulmonary emboli.
Massive right renal mass (17 cm), with enhancing tumor thrombus in the IVC.
Retroperitoneal adenopathy.
Bulky, lobulated left pelvic sidewall/space of Retzius adenopathy with surrounding fatty proliferation.
Case Discussion
There is a lot going on in this case. The major teaching point here is that the left pelvic sidewall adenopathy looks different from the retroperitoneal adenopathy suggesting that it is a different process. In this case, lymphoproliferative disorder was favored and US-guided biopsy was recommended for both the renal mass and left lower quadrant adenopathy separately.
Final pathology showed that the RP lymph nodes were due to RCC mets, and the left lower quadrant nodal mass was unicentric Castleman disease.
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