PMC10163335_01
(A) Left kidney not visualized in the left renal fossa; (B) Well-defined solid mass of heterogeneous echotexture arising from isthmus of HSK.
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F1
A well-defined sold mass of heterogeneous echotexture with few hypoechoic areas within the lesion was seen arising from the upper portion of isthmus (Figure 1).
Contrast-enhanced CT coronal sections showing medially deviated lower poles of the bilateral kidneys with heterogenous enhancing mass arising from the superior portion of isthmus of the HSK abutting the hilum of right kidney.
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F2
It was extending anterior to right renal hilum and abutting anterosuperior surface of right renal pelvis (Figure 2).
(A-D) Axial contrast enhanced CT abdomen showing well-defined heterogeneously enhancing solid mass arising from isthmus compressing and displacing adjoining second and proximal third portion of the duodenum (arrow in [A]).
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F3
(A-D) Contrast enhanced CT sagittal images:Mass arising from the isthmus, posteriorly compressing the IVC with obliteration of intervening fat planes (arrow).
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F4
IVC as a result was compressed and flattened anteroposteriorly (Figure 4).
Three-dimensional volume rendering CT angiography showing renal and accessory arteries on either sides supplying both kidneys. Another artery arising from infra renal aorta supplying isthmus, tumor, and adjoining lower pole of right kidney.
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F5
Another artery arising from infra renal abdominal aorta on the right side at the level of third lumbar vertebra trifurcated the medial branch that supplied isthmus, middle branch that supplied tumor, and lateral branch that supplied the right kidney (Figure 5).