Presentation
Microscopic hematuria.
Patient Data
A 32 mm intra-parenchymal mass is seen in the lower pole of the right kidney. The neoplasm has a similar density to normal renal parenchyma on non-enhanced CT scan images. After IV contrast media injection, the attenuation value increased from 28 HU to 93 HU. Nephrographic-phase CT scan shows that the mass enhances less than normal renal parenchyma.
There is no sign of local invasion, no vascular extension and no regional enlarged lymph nodes.
Case Discussion
A partial nephrectomy was performed for the right renal mass and histopathology evaluation confirmed a renal cell carcinoma, clear cell subtype - T1aN0M0 - Stage I.
The TNM system may be used for staging renal cell carcinoma, and if the tumor is confined to the kidney with a size <4 cm it is T1a.
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