Presentation
Right flank pain and mild dysuria for 1 month. No hematuria, or fever.
Patient Data
A well-defined mildly hyperechoic lesion measuring 2.0 x 2.5 cm is seen at the mid pole of right kidney. No significant internal vascularity is seen in it on color Doppler ultrasound examination.
Findings: A well-defined oval-shaped heterogeneously enhancing mass lesion measuring 2.5 x 2.3 cm is seen involving the anterior mid pole of the right kidney. No necrosis, calcification or fatty component is seen. No renal vein or IVC thrombosis is seen. No evidence of metastasis is seen. A tiny cortical cyst is noted in either kidney.
Impression: Small well-defined heterogeneously enhancing right renal mass lesion most likely representing a renal cell carcinoma. T1a, N0, M0 (Stage 1).
Findings: A well-defined oval-shape lesion measuring about 2.0 x 2.0 cm is seen at the midpole of right kidney. The lesion is isointense on T1 & T2 weighted images, and has a small cystic component medially. No fat, calcification, or hemorrhage is seen in it. No significant diffusion restriction is seen in the lesion. It shows heterogeneous enhancement in arterial & portovenous study and some areas of washout in the delayed phase.
Impression: Right renal mass likely a stage I renal cell carcinoma.
Case Discussion
Patient underwent right partial nephrectomy.
Histopathology: Renal oncocytoma (benign) measuring 2 cm in diameter.