case_images: PMC10847627_01
case_images: A well-defined heterogeneously enhancing solid cystic mass lesion measuring approximately (3.8 x 3.6 x3.4 cm) involving the lower pole of the right kidney. There was no evidence of extension of the lesion into the pararenal space and the right renal artery and vein appeared normal radiologically; this was provisionally diagnosed as renal cell carcinoma (RCC).
case_images: cureus-0016-00000051824-i01.jpg
case_images: PMC10847627_01_cureus-0016-00000051824-i01.jpg
case_images: FIG1
case_images: Subsequently, a contrast-enhanced computed tomography scan (CECT) revealed a well-defined, heterogeneously enhancing, solid cystic mass in the lower pole of her right kidney, measuring approximately 3.8 x 3.6 x 3.4 cm as shown in Figure 1.
case_images: The kidney was normal, but the cut surface showed a solid mass with focal cystic areas (3 x 2 cm) occupying the lower pole of the kidney. The solid area was firm, glistening white to focally yellowish.
case_images: cureus-0016-00000051824-i02.jpg
case_images: PMC10847627_01_cureus-0016-00000051824-i02.jpg
case_images: FIG2
case_images: A gross examination of the kidney showed a normal appearance with a solid mass, including focal cystic areas measuring 3 x 2 cm, primarily occupying the lower pole as shown in Figure 2.
case_images: Histopathological examination (HPE) revealed a well-circumscribed tumor with an intimate mix of smooth muscle, disorganized blood vessels, and adipose tissues
case_images: cureus-0016-00000051824-i03.jpg
case_images: PMC10847627_01_cureus-0016-00000051824-i03.jpg
case_images: FIG3
case_images: The tumor displayed a mixed solid and cystic architecture, with cuboidal epithelial linings in the cysts and a compact cellular layer underneath as shown in Figure 3.
case_images: On immunohistochemistry (IHC), the epithelial lining of cystic spaces showed positivity for pancytokeratin (CK), estrogen-receptor alpha (ER) seen in stromal cells, smooth muscle actin (SMA) strongly positive in the stromal component and blood vessels; patchy weakly positive HMB45 seen in the cambium layer
case_images: cureus-0016-00000051824-i04.jpg
case_images: PMC10847627_01_cureus-0016-00000051824-i04.jpg
case_images: FIG4
case_images: Immunohistochemistry (IHC) demonstrated positive staining for pancytokeratin (CK) in the epithelial lining of the cystic spaces, estrogen-receptor alpha (ER) in stromal cells, and strong smooth muscle actin (SMA) positivity in the stromal component and blood vessels, along with weakly positive HMB45 in the cambium layer as shown in Figure 4.