case_images: PMC8121607_01
case_images: Ultrasound showing malignant looking left renal mass with mixed solid and cystic component.
case_images: CRIRA2021-6625689.001.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.001.jpg
case_images: fig1
case_images: Score (NEWS) was 1 (blood tests outlined in Table 1). She was referred for abdominopelvic ultrasonography which revealed left renal mass around 18 cm with a mixed solid and cystic component; also, hypoechoic foci were noted within the pancreas (Figures 1 and 2).
case_images: Ultrasound showing hypoechoic masses within the pancreas.
case_images: CRIRA2021-6625689.002.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.002.jpg
case_images: fig2
case_images: Score (NEWS) was 1 (blood tests outlined in Table 1). She was referred for abdominopelvic ultrasonography which revealed left renal mass around 18 cm with a mixed solid and cystic component; also, hypoechoic foci were noted within the pancreas (Figures 1 and 2).
case_images: CT showing confirmed a large malignant looking left renal mass with central necrosis.
case_images: CRIRA2021-6625689.003.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.003.jpg
case_images: fig3
case_images: Subsequent chest CT and CT urogram were done and confirmed a large left renal mass of 18 cm x 10 cm x 12 cm with central necrosis and peripheral hypervascularity (Figure 3).
case_images: Follow-up CT of the abdomen showing liver deposits.
case_images: CRIRA2021-6625689.004.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.004.jpg
case_images: fig4
case_images: Initially, the patient had shown stable minimal progress of the metastatic disease for which systemic therapy was not indicated at that time. 16-month postnephrectomy, CT follow-up revealed stable chest disease with new hepatic metastasis for which she started sunitinib treatment (Figure 4).
case_images: CT of the brain with contrast showing brain metastasis with surrounding edema.
case_images: CRIRA2021-6625689.005.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.005.jpg
case_images: fig5
case_images: Three months later, brain CT showed brain metastasis after she got an episode of confusion (Figure 5).
case_images: (a) Bilateral mammogram MLO view showing rounded density in the upper part of the right breast. (b) Mammogram in CC view showing a rounded right breast dense lesion.
case_images: CRIRA2021-6625689.006.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.006.jpg
case_images: fig6
case_images: Bilateral mammography showed a dense new mass lesion as compared to her previous mammogram done 2 years earlier (Figures 6 and 7).
case_images: New lesion as compared to previous mammogram.
case_images: CRIRA2021-6625689.007.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.007.jpg
case_images: fig7
case_images: Bilateral mammography showed a dense new mass lesion as compared to her previous mammogram done 2 years earlier (Figures 6 and 7).
case_images: US showing a hypoechoic solid mass lesion in the right breast at 1 o'clock.
case_images: CRIRA2021-6625689.008.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.008.jpg
case_images: fig8
case_images: U5 in ultrasound. US-guided core biopsy was done in the same clinic (Figure 8).
case_images: The standard H&E-stained section showing cells with small nuclei and abundant clear cytoplasm typical of clear cell RCC.
case_images: CRIRA2021-6625689.009.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.009.jpg
case_images: fig9
case_images: A panel of immunohistochemical markers reveals positive staining with the renal markers PAX 8 and carbonic anhydrase (Figures 9-11).
case_images: Image shows positive immunohistochemical cell nucleus staining with PAX8.
case_images: CRIRA2021-6625689.010.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.010.jpg
case_images: fig10
case_images: A panel of immunohistochemical markers reveals positive staining with the renal markers PAX 8 and carbonic anhydrase (Figures 9-11).
case_images: Image shows positive cell membrane staining with carbonic anhydrase.
case_images: CRIRA2021-6625689.011.jpg
case_images: PMC8121607_01_CRIRA2021-6625689.011.jpg
case_images: fig11
case_images: A panel of immunohistochemical markers reveals positive staining with the renal markers PAX 8 and carbonic anhydrase (Figures 9-11).