case_images: PMC10561617_01
case_images: Axial (A-D) and coronal (E-F) sections of abdominal contrast-enhanced computed tomography showing a diffusely enhanced tumor (10 cm in size) in the left kidney (plain, (A); early phase, (B); nephrographic phase, (C). The tumor thrombus extended beyond the bifurcation of the hepatic vein (white arrow, (E). After pharmacotherapy, the internal density of the tumor decreased in the early phase (D) and the tumor thrombus was significantly shortened (white arrow, (F).
case_images: RRU-15-447-g0001.jpg
case_images: PMC10561617_01_RRU-15-447-g0001.jpg
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case_images: Abdominal computed tomography (CT) revealed a 10-cm left renal tumor extending to the IVC (Figure 1A-C and E). The tumor had no fatty components and was diffusely enhanced on contrast CT (Figure 1A-C), suggesting RCC. Post-treatment CT showed favorable treatment outcomes, including reduction of the contrast effect in the primary tumor and reduction in the length of the tumor thrombus below the bifurcation of the hepatic vein (Figure 1D and F).
case_images: Macro (A), microscopic appearance (B and C) and immunohistochemical findings (D-F) are shown: tan-brown colored renal tumor, 15x10 cm in size with hemorrhage and necrosis located in the lower pole of the kidney (A). Necrosis was observed (white allows, (B). Tumor cells with severe atypia and eosinophilic cytoplasm proliferated in papillary architecture (C). The cells were positive for Melan A (D) and cathepsin K (E) in immunohistochemistry. Scale bars: 100 mum.
case_images: RRU-15-447-g0002.jpg
case_images: PMC10561617_01_RRU-15-447-g0002.jpg
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case_images: The gross appearance of the cross-section revealed a 15x10 cm tan-brown renal tumor with hemorrhage and necrosis (Figure 2A). Histological sections demonstrated that tumor cells with severe atypia and abundant eosinophilic cytoplasm proliferated and infiltrated diffusely or formed a vague papillary architecture (Figure 2B and C). Immunohistochemical staining revealed tumor cell positivity for Melan A (partly, Figure 2D), cathepsin K (partly, Figure 2E), CD10 (partly), and c-KIT (partly and weakly).