Presentation
Incidental finding of a right renal lesion on routine imaging.
Patient Data
Small well defined isoechoic exophytic solid nodule measuring 14 x 17 mm at the mid pole of the right kidney. No vascularity is seen in it on color Doppler ultrasound examination.
A well-defined exophytic soft tissue nodule measuring 17.3 x 14.4 mm, is seen at the mid pole of right kidney. It has an average density of 45, 63 and 95 Hounsfield units on plain, arterial and portovenous phases respectively. Right renal vein is patent. IVC is patent. No significant loco-regional lymphadenopathy is seen. Adrenal glands and left kidney are normal. Bilateral prominent extrarenal pelvis (anatomical variant). No evidence of distant metastasis is seen. Mildly enlarged fatty liver and small simple left ovarian cyst.
Histopathology report of the right partial nephrectomy shows papillary renal cell carcinoma (pRCC), measuring 17 mm approximately, invading the renal capsule and perinephric fat.
Case Discussion
Small well-defined exophytic right renal lesion, suspicious for a malignancy. The lesion is mildly hyperdense and mildly enhancing on the CT scan.
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