PMC8481033_01
CT images of the patient. (a) A coronal section illustrating the hydronephrotic right kidney (*) due to the obstruction caused by the lower ureteric tumour and the left kidney with a contrast enhancing mass in the lower pole (**) and a simple cyst in the upper pole (arrow). (b) A coronal section through the left renal mass. (c) An axial section showing the right ureteric tumour (arrow) in relation to the posterior wall of the bladder (*).
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In the left kidney, there was an enhancing, exophytic mass, measuring 43 x 38 mm involving the lower pole (Nephrometry/RENAL score 5a) (Figure 1).
Right ureteric tumour. (a) Ureteroscopic view of the tumour completely obstructing the lumen of the ureter. (b) Macroscopic view of the separately resected tumour with a bladder cuff. (c) Cut surface appearance of the tumour. (d) x10 view illustrating the nests of malignant (*) cells invading the muscularis propria of the ureter (arrow).
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However, there was evidence of invasion of periureteric fat (pT3N0M0) (Figure 2).
Left renal cell carcinoma. (a) Macroscopic appearance of the resected tumour. (b) Histology showing typical clear cell carcinoma.
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Histology of which revealed a low-grade (ISUP grade 2) ccRCC without sinus fat or capsular involvement, and the resection margins were negative (pT1bNxM0) (Figure 3).