Presentation
Acute and new onset of frank hematuria. A history of significant weight loss is confirmed clinically. No other renal or abdominal complaints.
Patient Data
CT imaging demonstrates a solid, left intrarenal, mid and lower pole, circumscribed mass lesion with heterogeneous enhancement on multiphasic imaging. There is a central stellate scar, no associated calcification or intralesional hemorrhage. There is draping of the calyceal system. Some capsular bulging is noted, however no extracapsular extension. There is no renal vein thrombosis, a normal IVC, and no hepatic or lung basal metastases. There are no ascites or suspicious lymph nodes.
Case Discussion
The lesion has typical features suggestive of a renal oncocytoma. Renal cell carcinoma cannot be definitively excluded on imaging alone and especially in view of the presenting history. In this instance, in view of the weight loss, macroscopic hematuria and large size, a complete nephrectomy was performed. Excision histopathological diagnosis confirmed a benign left renal oncocytoma.
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