Presentation
Work up for gross hematuria and left flank pain.
Patient Data
A 103×79 mm hetero enhancing mass infiltrates the upper pole and urinary collecting system of the left kidney and proximal left ureter, causing lower pole hydronephrosis. Left renal vein tumoral infiltration is also observed without IVC involvement. Perinephric fat stranding and several para aortic enlarged lymph nodes are seen with a maximum SAD of 15 mm.
The hepatic attenuation value is less than the spleen, suggesting fatty liver disease.
The gallbladder is not seen at the anatomical location due to prior resection.
A 22 mm simple cortical cyst is noted at the upper pole of the right kidney.
Case Discussion
The patient underwent the left nephroureterectomy, and histopathology confirmed poorly differentiated urothelial cell carcinoma (non-papillary subtype).
Unlike renal cell carcinomas that tend to distort the renal outline, even large infiltrating urothelial cell carcinomas maintain a normal renal shape.
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