Presentation
Work up for hematuria and right flank pain.
Patient Data
A 100×68×70 mm mass is seen in the lower pole of the right kidney. The neoplasm has a similar density to normal renal parenchyma on a nonenhanced CT scan. After IV contrast media injection, the attenuation value increased from 35 to 67 HU. A nephrographic phase CT scan shows that the mass enhances less than normal renal parenchyma.
An enlarged lymph node with SAD of 9 mm is present in the paracaval region adjacent to the renal hilum. There are no sign of local invasion to the adjacent structures and no vascular extension.
A 12 mm stone is noted at the upper calyx of the right kidney.
The prominent median umbilical ligament is seen.
Case Discussion
The patient underwent right nephrectomy and histopathology evaluation confirmed renal cell carcinoma (clear cell type).