case_images: PMC6468145_01
case_images: Magnetic resonance imaging, (A) coronal T2W image showing normal both adrenal glands (red circle :Rt adrenal, yellow circle :Lt adrenal), (B) Gadolinium enhanced T1W axial image showing contrast enhanced upper pole renal mass with normal looking Lt adrenal gland.
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case_images: Further evaluation with abdominal Magnetic Resonance Imaging revealed a mass in the upper pole of the left kidney with radiologic characteristics of renal cell carcinoma (Fig. 1).
case_images: contrast enhanced CT scan of the abdomen. Coronal (A) and axial (B) sections showing an enhanced right adrenal mass (red circle) and normal looking left adrenal gland (yellow circle).
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case_images: In dynamic study the solid component showed significant enhancement after intravenous contrast administration (Fig. 2).
case_images: Completely excised right adrenal gland with the mass.
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case_images: Under general anesthesia, in left lateral position through right transcostal incision, right adrenalectomy was done (Fig. 3).
case_images: Histologic appearance of clear cell renal cell carcinoma on hematoxylin and eosin stain showing polygonal cells with marked clear cytoplasm and medium-sized nuclei with prominent nucleoli arranged in sheets and tiny clusters.
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case_images: Pathological examination revealed morphological and immunohistochemical findings in line with metastatic renal cell carcinoma, including positive staining for AE1/AE3, cytokeratin 7, vimentin, and CD10, and negative staining for CDX-2, inhibin, and synaptophysin (Fig. 4, Fig. 5).