case_images: PMC9448560_01
case_images: Contrast sagittal section shows a large hematoma at the left retroperitoneal region (blue arrow), the normal-appearing left kidney (thin red arrow), and an exophytic left upper pole renal mass (red arrowhead).
case_images: CRIN2022-6882451.001.jpg
case_images: PMC9448560_01_CRIN2022-6882451.001.jpg
case_images: fig1
case_images: Subsequent computed tomography (CT) of abdomen and pelvis showed an exophytic upper pole cortical mass (red arrowhead) in the left kidney (red arrow) measuring 7 x 4.5 x 7.3 cm in transverse, anterior-posterior, and craniocaudal diameter, respectively (Figure 1).
case_images: Contrast axial view section shows an ill-defined margin between the exophytic mass and the kidney (curved yellow arrow).
case_images: CRIN2022-6882451.002.jpg
case_images: PMC9448560_01_CRIN2022-6882451.002.jpg
case_images: fig2
case_images: An axial image showed an ill-defined margin between the mass and the kidney denoted by a curved yellow arrow (Figure 2).
case_images: Green arrow shows a contrast extravasation consistent with active bleeding.
case_images: CRIN2022-6882451.003.jpg
case_images: PMC9448560_01_CRIN2022-6882451.003.jpg
case_images: fig3
case_images: A focal rounded area of intense enhancement (green arrow) was seen on arterial phase images consistent with active low-intensity bleeding (Figure 3).
case_images: Postoperative left nephrectomy specimen with evacuated 3.5 L blood and clots.
case_images: CRIN2022-6882451.004.jpg
case_images: PMC9448560_01_CRIN2022-6882451.004.jpg
case_images: fig4
case_images: The patient was then scheduled for surgery, which included a left nephrectomy with complete mass excision, and a total of 3.5 liters of blood and clots were removed from the peritoneum (Figure 4).
case_images: Gross anatomy specimen showing the exophytic renal cortical tumor incontinuity with the renal cortex (black arrow).
case_images: CRIN2022-6882451.005.jpg
case_images: PMC9448560_01_CRIN2022-6882451.005.jpg
case_images: fig5
case_images: Gross anatomy specimen is kidney with attached tumor size of 7 cm (Figure 5).
case_images: On low magnification, the left side shows normal-looking renal tubules and the right side shows the fatty tissue with round blue cells consistent with tumor cells.
case_images: CRIN2022-6882451.006.jpg
case_images: PMC9448560_01_CRIN2022-6882451.006.jpg
case_images: fig6
case_images: Histology: on low magnification, the left side shows normal-looking renal tubules and the right side shows the fatty tissue with round blue cells consistent with tumor cells (Figure 6).
case_images: On high magnification, remarkable cellularity, granular cytoplasm, and central or slightly eccentric nuclei are observed. There are no abnormal mitosis and mild nuclear pleomorphism.
case_images: CRIN2022-6882451.007.jpg
case_images: PMC9448560_01_CRIN2022-6882451.007.jpg
case_images: fig7
case_images: No cellular spindling or necrosis was seen (Figure 7).