PMC6468145_01
Magnetic resonance imaging, (A) coronal T2W image showing normal both adrenal glands (red circle :Rt adrenal, yellow circle :Lt adrenal), (B) Gadolinium enhanced T1W axial image showing contrast enhanced upper pole renal mass with normal looking Lt adrenal gland.
gr1.jpg
PMC6468145_01_gr1.jpg
fig0005
Further evaluation with abdominal Magnetic Resonance Imaging revealed a mass in the upper pole of the left kidney with radiologic characteristics of renal cell carcinoma (Fig. 1).
contrast enhanced CT scan of the abdomen. Coronal (A) and axial (B) sections showing an enhanced right adrenal mass (red circle) and normal looking left adrenal gland (yellow circle).
gr2.jpg
PMC6468145_01_gr2.jpg
fig0010
In dynamic study the solid component showed significant enhancement after intravenous contrast administration (Fig. 2).
Completely excised right adrenal gland with the mass.
gr3.jpg
PMC6468145_01_gr3.jpg
fig0015
Under general anesthesia, in left lateral position through right transcostal incision, right adrenalectomy was done (Fig. 3).
Histologic appearance of clear cell renal cell carcinoma on hematoxylin and eosin stain showing polygonal cells with marked clear cytoplasm and medium-sized nuclei with prominent nucleoli arranged in sheets and tiny clusters.
gr4.jpg
PMC6468145_01_gr4.jpg
fig0020
Pathological examination revealed morphological and immunohistochemical findings in line with metastatic renal cell carcinoma, including positive staining for AE1/AE3, cytokeratin 7, vimentin, and CD10, and negative staining for CDX-2, inhibin, and synaptophysin (Fig. 4, Fig. 5).