Renal complex cyst (Bosniak category IV)

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Work up for hematuria.

Patient Data

Age: 65 years
Gender: Male

A 58 mm complex cystic mass with enhancing solid components is noted at the lower portion of the left kidney. The solid components of the lesion are enhanced. There is no sign of vascular invasion and adjacent organs involvement.
A few cortical cysts are seen at the kidneys, and the left renal vein has a retro aortic course. 
The prostate gland is enlarged. 

Case Discussion

The left renal complex cystic mass with enhancing solid components that inferring Bosniak category IV.

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

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