Renal cell carcinoma
Left flank pain. work up for hematuria.
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A 77 × 59 × 55 mm mass is seen in the lower pole of the kidney. The neoplasm has a similar density to normal renal parenchyma on non-contrast CT scan, with thin peripheral calcification. After contrast media injection, the attenuation value increased from 37 HU to 70 HU. Nephrographic-phase CT scan shows that the mass enhances less than normal renal parenchyma with some cystic/necrotic components. The mass bulged into lower portion of pelvicalyceal system. Renal vein is intact. Fat plane between the mass and adjacent psoas muscle is obliterated, but there is no definite sign in favor of local invasion. No regional or para-aortic lymphadenopathy.
The patient underwent left nephrectomy and histopathologic findings were consistent with clear cell renal carcinoma.