Renal cell carcinoma
Right flank pain and hematuria.
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An 88×66 mm heterogeneous enhancing partially exophytic mass is noted at superior aspect of right kidney. There are no sign of local invasion to adjacent structures, no vascular extension and no regional lymphadenopathy. Malposition of left kidney is evident with anteriorly rotated hilum.
The prostate gland is enlarged.
Several lymphadenopathies with central necrotic changes are seen at left para-iliac regions with maximum short axis diameter of 40 mm.
Degenerative changes as osteophytosis are seen at the lumbar spine.
The patient presented with macroscopic hematuria and right flank pain which are two of the classic presentation triad of renal cell carcinoma, consisting of hematuria, flank pain and a palpable mass.
Correlated with the imaging findings, the patient was diagnosed with renal cell carcinoma. Radical nephrectomy was performed. Histopathology confirmed the diagnosis of renal cell carcinoma.