case_images: PMC9852041_01
case_images: Enhanced computed tomography scan: A round low-denisty cystic mass located at the renal helium, measuring 7.4 x 7.4 cm in size with a width of 0.5 cm at the wall. (A) Arterial phase (B) Venous phase.
case_images: fsurg-09-1053852-g001.jpg
case_images: PMC9852041_01_fsurg-09-1053852-g001.jpg
case_images: F1
case_images: No abnormalities were observed in the right kidney. (Figure 1) Pulmonary CT findings were as follows.
case_images: Immunohistochemistry results: (A) CDX2(+): diffuse and strong nuclear immunoreactivity for CDX2. (B) CEA(+): diffuse strong staining for the CEA. (C) CK20(+): atypical mucinous epithelium with patchy cytokeratin 20 staining. (D) MUC2(+) and (E) MUC5AC(+): atypical mucinous epithelium with diffuse strong staining for the MUC2 and MUC5AC gene products (x20) (F) pathology: a wide range of mucus lake was observed under the microscope, and the areas of the cyst wall are lined by atypical mucinous epithelium (H&E staining) (x20).
case_images: fsurg-09-1053852-g002.jpg
case_images: PMC9852041_01_fsurg-09-1053852-g002.jpg
case_images: F2
case_images: In the gross specimen, a mass measuring 7 x 7 cm was observed near the hilum of the left kidney and was associated with the ureter. (Figure 2A) After dissection along the vertical axis, there was an outflow of yellowish gelatinous material, and no neoplasm invasion was found in the renal pelvis or ureter. (Figure 2B) During surgery, approximately 800 ml blood was lost; therefore, 400 ml of plasma and 4 U of red blood cells were infused, and no transfusion reaction was observed.
case_images: Fresh specimen of the left kidney with mass after radical resection. (A) Gross specimen: The tumor was associated with the kidney and located at the inferior pole. (B) Resection along the vertical axis: The tumor has a large amount of mucus with a focal grayish yellow appearance and thin wall. (C) The ports implacement.
case_images: fsurg-09-1053852-g003.jpg
case_images: PMC9852041_01_fsurg-09-1053852-g003.jpg
case_images: F3
case_images: The image showed mucinous epithelium and a large amount of mucus. (Figure 3F) Immunohistochemical results were as follows: CDX-2(+), Villin(+), CK7(-), CK20(+), CEA(+), MUC2(+), MUC5AC(+), ER(-), PR(-), P16(-), and CA125(-). (Figures 3A-E) Low-grade mucinous adenocarcinoma of the left kidney was pathologically diagnosis; however metastasis was not diagnosed, suggesting the clinical examination of the appendix.