case_images: PMC11754233_01
case_images: CT and CECT images. The left renal shows significant enlargement with distorted morphology, irregular dilation of renal pelvis and calyces, thinning of renal parenchyma, unclear demarcation of cortex and medulla, and heterogeneous enhancement (blue arrow). The perirenal fascia and the paracolic sulcus peritoneum on the left side are swollen (yellow arrow). The enlarged lymph nodes are observed beside the abdominal aorta (red circle). (A), CT image. (B), CECT image cortical period.
case_images: fonc-14-1511009-g001.jpg
case_images: PMC11754233_01_fonc-14-1511009-g001.jpg
case_images: f1
case_images: The patient's CT and contrast-enhanced CT (CECT) images were shown in  Figure 1 .
case_images: Two-dimensional ultrasound images. (A) The left renal showed abnormal morphology, with a tumor of mixed echogenicity observed internally, measuring 12x8 cm in size. The tumor has indistinct borders, an irregular shape, and displays heterogeneous internal echoes. (B) Drainage tube sound shadow (white arrow). (C) Left renal calculi (yellow arrow). (D) Renal hilar vascular structure was normal. (E) Blood signal in the tumor (Alder grade II). (F) Enlarged lymph nodes adjacent to the abdominal aorta.
case_images: fonc-14-1511009-g002.jpg
case_images: PMC11754233_01_fonc-14-1511009-g002.jpg
case_images: f2
case_images: The patient's two-dimensional ultrasound was shown in  Figure 2 .
case_images: CEUS images. (A-D), The upper part of the tumor. (A, B), Cortical phase: At 11 seconds and 30 seconds, the tumor showed heterogeneous rapid and intense enhancement with fissure-like non-enhancing areas within. (C), Medullary phase: 1 minute 8 seconds. The tumor shows persistent heterogeneous hyperenhancement with fissure-like non-enhancement within. (D), Parenchymal washout phase: At 1 minute and 44 seconds, the tumor showed washout with hypoenhancement. (D-G), The lower part of the tumor. (E, F), Cortical phase: At 9 seconds and 33 seconds, the tumor showed heterogeneous rapid and intense enhancement with fissure-like non-enhancing areas within. (G), Medullary phase: 58 seconds. The tumor shows persistent heterogeneous hyperenhancement with fissure-like non-enhancement within. (H), Parenchymal washout phase: At 1 minute and 43 seconds, the tumor showed washout with hypoenhancement.
case_images: fonc-14-1511009-g003.jpg
case_images: PMC11754233_01_fonc-14-1511009-g003.jpg
case_images: f3
case_images: The CEUS images were shown in  Figure 3 .
case_images: Pathology. (A) HE (x4); (B) HE (x20); (C) PCK (+, x20); (D) CK7 (+, x20); (E) Pax-8 (+, x20); (F) Ki-67 (about 60%, x20). HE: hematoxylin-eosin.
case_images: fonc-14-1511009-g004.jpg
case_images: PMC11754233_01_fonc-14-1511009-g004.jpg
case_images: f4
case_images: The pathology are shown in  Figure 4 .