Presentation
Dysuria for one week and mild in severity. KUB ultrasound was requested for evaluation
Patient Data
Ultrasound showed a well-defined right renal round heterogeneous focal mass lesion measuring 4 cm in diameter. No appreciable vascularity by color Doppler.
Further evaluation by CT with contrast is required.
A rounded heterogeneous mass measuring 4 x 3.5 cm is seen arising from the upper pole of the right kidney. To a lesser degree, the mass shows moderate heterogeneous enhancement on post-contrast scans than the adjoining renal parenchyma. Multiple internal cystic/necrotic areas are seen in the mass. There is no renal sinus fat, renal pelvis, renal vein, or IVC involvement. There is no involvement of the perinephric fat. There is no regional lymphadenopathy. The rest of the right kidney appears normal
Total right nephrectomy was done and sent to the laboratory for histopathology.
Result: Leiomyoma with degenerative changes.
Case Discussion
A case of an incidentally found, asymptomatic, right kidney mass seen by ultrasound.
Initial suspicions on CT imaging of either renal cell carcinoma or benign mass lesion resulted in a radical nephrectomy of the right kidney.
Postoperative pathological examination of the mass revealed a renal leiomyoma, a rare, benign tumor that is mostly indistinguishable from malignant tumors on imaging.
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