case_images: PMC11783215_01
case_images: Contrast enhanced magnetic resonance imaging (MRI) of the orbit. (A) Coronal and (B) Axial T1 post-contrast images showing a hyperintense lesion with soft tissue component measuring 3.5 x 3 x 3.5 cm located in the right orbit (yellow arrow). It extends into intraconal region involving right temporalis muscle with lytic destruction of right greater wing of sphenoid and orbital process of frontal bone.
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case_images: It is seen involving the right temporalis muscle and also extending into intraconal region of the right orbit indenting the superior and lateral rectus muscles and the superior ophthalmic vein with mild deviation but no infiltration of the optic nerve (Fig. 1).
case_images: Contrast enhanced computed tomography (CT) of thorax and abdomen. (A) Coronal and (B) Axial images showing a large heterogeneously enhancing soft tissue mass lesion measuring 16 x 13.1 x 12.1 cm arising from the upper pole of the left kidney (yellow arrow). Well circumscribed lytic lesion measuring 6.6 x 4.5 x 4.7 cm arising from the lateral aspect of right 4th rib (red arrow). Multiple enhancing mass lesions in the liver parenchyma (blue arrow).
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case_images: A surveillance computed tomography (CT) revealed a lytic mass lesion involving the upper pole of the left kidney with metastases to the liver, right 4th rib, left thyroid gland, and lungs (Fig. 2).
case_images: Histopathological examination of tru-cut biopsy specimen of the left kidney mass with hematoxylin and eosin staining showing tumor cells with abundant clear cytoplasm that are vacuolated with indistinct cell borders pathognomonic for clear cell renal cell carcinoma.
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case_images: To confirm the primary malignancy, an ultrasound-guided tru-cut biopsy of the mass in the left kidney was performed, histopathology confirmed the diagnosis of clear cell renal carcinoma (Fig. 3).