Presentation
Left flank pain.
Patient Data
There is paucity of bowel gas at the left side of the abdomen with loss of clear definition of the left psoas muscle.
A left renal large mass lesion is seen exophytic from the lower pole with a heterogeneous post-contrast enhancement. It is invading the pelvicalyceal system. It has related large renal hilar metastatic lymph nodes, one of them shows central breakdown.
Case Discussion
Whenever a young patient is presented with flank pain, renal calculi are the primary suspect, cause of that a non-enhanced CT would be the primary line of investigation, as what had been done in this case. But once a tumor is detected, proceeding with a contrasted study must ensue.
Path proved clear cell renal cell carcinoma.