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Renal cell carcinoma with collecting system involvement

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Work up for gross hematuria.

Patient Data

Age: 75 years
Gender: Male

An 80×75 mm hetero-enhancing mass with areas of cystic necrosis is present at the upper pole of the left kidney and extends into the collecting system. Several dominant lymph nodes are seen in the para-aortic region.

A 25 mm simple cortical cyst is present at the lower pole of the left kidney. 

A Foley catheter is inserted in the urinary bladder. A 45 mm relatively hyperdense non-enhanced lesion is observed in the urinary bladder most consistent with a clot.

Minimal anterior displacement of L5 over S1 is also present. 

Case Discussion

The patient underwent a left nephrectomy, and histopathology evaluation confirmed renal cell carcinoma (clear cell subtype).

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