Presentation
Right upper quadrant pain.
Patient Data
7.4cm mass in the lower pole of the right kidney.
This is largely solid with an adjacent cystic element.
6cm solid enhancing mass in the lower pole of the left kidney with a central stellate area of low attenuation.
Separate simple cyst abutting the mass as well as a further simple cortical cyst in the left mid pole.
Normal right kidney.
No para-aortic lymphadenopathy.
Case Discussion
Renal oncocytomas and renal cell malignancies can be very difficult to distinguish. The practical reality is that the mass is surgically removed, although nephron sparing surgery may be undertaken if the benign histology is known in advance.
With the widespread use of cross sectional imaging renal cell malignancies are most commonly identified incidentally so it is just as likely as an oncocytoma to be asymptomatic at presentation.
This case does show the chief suggestive feature of an oncocytoma - a central stellate scar.
The post operative histology was of an oncocytoma.
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