Presentation
Left flank pain and hematuria.
Patient Data
A 93×73×77 mm mass is seen in the lower pole of the left kidney. The neoplasm has a similar density to normal renal parenchyma on a non-enhanced CT scan. After IV contrast media injection, the attenuation value increased from 40HU to 88HU. Nephrographic phase CT scan shows that the mass enhances less than normal renal parenchyma. The mass involves the left renal collecting system, but there are no signs of local invasion to adjacent structures and no vascular extension.
Several lymphadenopathies are observed at left paraaortic regions with SAD less than 10 mm.
In imaged portions of the lower thorax, several pulmonary nodules are seen at both lung fields less than 28 mm.
Case Discussion
The left renal mass; pathology proved renal cell carcinoma (clear cell subtype), with paraaortc lymphadenopathies and pulmonary metastases.