Presentation
Previous episode of hematuria
Patient Data
There is a large left-sided necrotic renal mass with few foci of calcification. The mass demonstrates heterogeneous enhancement in the post-contrast study and it extends beyond the gerota's facia(notice the mass waisting) with an invasion of the adjacent mesentery and bowel loops.
Splenomegaly and multiple enlarged necrotic lymph nodes also noticed. Chest CT scan reveal enlarged mediastinal lymph nodes and multiple cavitory masses consistent with metastasis.
Case Discussion
This patient had a previous episode of hematuria. He was visiting the doctor for other causes (limb paresthesia) and an abdominal ultrasound was performed which showed a large renal mass. Surgery was subsequently performed, and gross specimen histopathology revealed RCC with sarcomatous changes.
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