case_images: PMC9719804_01
case_images: Cross-sectional imaging of the patient (
  arrow
  : right renal mass;
  broken arrow
  : left renal mass). (
  A
  ) Out-of-phase T1 magnetic resonance sequence shows absence of fat. (
  B
  ) Diffusion-weighted T2 magnetic resonance sequence shows restricted diffusion. (
  C, D
  ) Contrast enhanced axial and coronal computerized tomography images show contrast uptake by both lesions.
case_images: 10-1055-s-0042-1759546-i2022050659-1.jpg
case_images: PMC9719804_01_10-1055-s-0042-1759546-i2022050659-1.jpg
case_images: FI2022050659-1
case_images: T2 images ( Fig. 1 ). There was a left lower lobe heterogeneous mass which was iso-intense on T1 and iso-/hyper-intense on T2 images. The parenchymas of both native kidneys were thin and atrophic in accordance with a renal disorder.
case_images: (
  A
  ) The excised right-sided tumor with prominent pseudocapsule which is friable and necrotic with areas of hemorrhage. (
  B
  ) Sectioning of the atrophic left kidney revealed the mass in renal parenchyma detected in horizontal serial sections
  (inset)
  . (
  C
  ) Microscopic examination revealed papillae or tubulopapillary architecture with fibrovascular cores. Papillae were lined by a single layer of cells with scant amount of pale cytoplasm and low nuclear grade (H&Ex200). (
  D
  ) The papillae contained numerous foamy macrophages (H&Ex200).
case_images: 10-1055-s-0042-1759546-i2022050659-2.jpg
case_images: PMC9719804_01_10-1055-s-0042-1759546-i2022050659-2.jpg
case_images: FI2022050659-2
case_images: The histopathological examination revealed a right-sided 70 x 60 x 50-mm and a left-sided 6 x 6 x 5-mm papillary RCCs both with CK7, AMACR, CD10, and vimentin expression ( Figs. 2 and 3 ).
case_images: (
  A-D
  ) Tumoral cells expressed CK7 (x200), AMACR (x200), CD10 (x400), and vimentin (x200).
case_images: 10-1055-s-0042-1759546-i2022050659-3.jpg
case_images: PMC9719804_01_10-1055-s-0042-1759546-i2022050659-3.jpg
case_images: FI2022050659-3
case_images: The histopathological examination revealed a right-sided 70 x 60 x 50-mm and a left-sided 6 x 6 x 5-mm papillary RCCs both with CK7, AMACR, CD10, and vimentin expression ( Figs. 2 and 3 ).