case_images: PMC7478167_01
case_images: Coronal view of computed tomography of abdomen/pelvis revealing a large left renal mass with direct extension into the left gonadal vein.
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case_images: PMC7478167_01_JKCVHL-7-001-g001.jpg
case_images: F1
case_images: Subsequent computed tomography (CT) imaging revealed a 16-cm left-sided renal mass with caudal tumor extension and bulky regional lymphadenopathy along the left gonadal vein (Figure 1).
case_images: Axial view of computed tomography of the abdomen and the pelvis revealing a heterogeneous appearance of the uterus.
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case_images: PMC7478167_01_JKCVHL-7-001-g002.jpg
case_images: F2
case_images: Upon further review of the abdominal and pelvic CT scan, there was a heterogeneous appearance of the uterus, which had been assumed to be related to fibroids (Figure 2).
case_images: Gross examination of the surgical specimen revealed a large necrotic left renal mass extending via the gonadal vein to the uterus and bilateral ovaries.
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case_images: PMC7478167_01_JKCVHL-7-001-g003.jpg
case_images: F3
case_images: The mass invaded the perinephric fat abutting Gerota's fascia, the hilar fat, calyces, and distorted the renal sinus (Figure 3). Grossly, the uterus showed approximately 70% of the endomyometrium involved by the tumor and necrosis, with diffuse tan-white nodularity on the serosal surface (Figure 3).
case_images: Microscopic evaluation of the tumor revealed nests of clear cells surrounded by interconnecting vascular framework, consistent with the ultimate diagnosis of clear cell renal cell carcinoma.
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case_images: F4
case_images: These findings rendered a diagnosis of left kidney clear cell RCC, which extended into the renal vein, left ovarian vein and uterus, left fallopian tube, and bilateral ovaries (Figure 4).