case_images: PMC5822868_01
case_images: Computed tomography with contrast (CT) coronal image demonstrates a heterogeneously enhancing hypodense right renal mid pole mass (red arrow) occupying the renal cortex and renal pelvis with mild surrounding fat stranding.
case_images: CRIPA2018-1837510.001.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.001.jpg
case_images: fig1
case_images: An abdominal computed tomography (CT) revealed an ill-defined infiltrative 4 cm renal mass in the mid to lower pole region of the right kidney, involving the renal parenchyma, renal hilum, and the renal pelvis (Figure 1).
case_images: Contrast enhanced computed tomography coronal image demonstrates tumoural thrombus within the right renal vein (red arrow).
case_images: CRIPA2018-1837510.002.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.002.jpg
case_images: fig2
case_images: Similar findings were also noted on a magnetic resonance imaging (MRI) which also revealed a tumour thrombus extending along the entire course of the right renal vein and projecting into the right side of the lumen of the inferior vena cava (Figure 2).
case_images: Right kidney with attached ureter showing tumour arising from the renal pelvis projecting into the proximal ureter and infiltrating the renal parenchyma.
case_images: CRIPA2018-1837510.003.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.003.jpg
case_images: fig3
case_images: A low power view of the papillary urothelial carcinoma projecting into the renal pelvis. Carcinoma in situ is present in the adjacent urothelial mucosa.
case_images: CRIPA2018-1837510.004.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.004.jpg
case_images: fig4
case_images: Carcinoma in situ involving the adjacent urothelium was noted (Figure 4).
case_images: Photomicrograph depicting high grade urothelial carcinoma with transformation to sarcomatoid carcinoma characterized by a spindle cell pattern.
case_images: CRIPA2018-1837510.005.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.005.jpg
case_images: fig5
case_images: Higher magnification photomicrograph featuring sarcomatoid component with spindle proliferation, nuclear pleomorphism, and increased mitotic activity.
case_images: CRIPA2018-1837510.006.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.006.jpg
case_images: fig6
case_images: Tumour thrombus from the inferior vena cava with high grade urothelial carcinoma and the sarcomatoid component.
case_images: CRIPA2018-1837510.007.jpg
case_images: PMC5822868_01_CRIPA2018-1837510.007.jpg
case_images: fig7
case_images: The tumour thrombus from the inferior vena cava was composed of high grade urothelial carcinoma along with the sarcomatoid component (Figure 7).