Presentation
Frank hematuria. No weight loss.
Patient Data
Large heterogeneous mass involving the majority of the kidney with a little sparing of the lower pole.
The tumor extends beyond the capsule and into a distended left renal vein.
Poor intravenous contrast opacification.
Large heterogeneous mass in the mid and upper poles of the left kidney extending into and distending the left renal vein. This extends into the infra-hepatic IVC.
Left hilar and para-aortic lymphadenopathy.
Right adrenal adenoma.
Gallstones.
Large renal tumor which is confluent extending into and completely occupying a distended left renal vein.
Case Discussion
An example of advanced renal cell carcinoma at presentation.
The tumor invasion of the left renal vein is profound - the vein being distended with tumor, and furthermore a tongue of tumor evident in the infra-hepatic IVC. This correlated with intra-operative findings and the resected specimen (shown).
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