PMC5345534_01
A, Magnetic resonance imaging (MRI) showing endophytic, posterior upper pole left renal mass (indicated by *), suspicious for carcinoma. B, Intraoperative photograph showing grossly invasive mass involving the lumen of the collecting system. T - Tumor; CS - collecting system; TF - tumor fossa.
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F1
When the hematuria persisted, magnetic resonance imaging (MRI) and computed tomography (CT) were performed, revealing a 3.6 x 3.2 x 2.5 cm left upper pole renal mass (Figure 1 A). However, upon entering the collecting system, the tumor was found to be inside the lumen (Figure 1 B).
High magnification photomicrograph showing highly infiltrative carcinoma with tubular structure, embedded in desmoplastic stroma. The tumor cells have eosinophilic cytoplasm (arrowhead), the nuclei are large and pleomorphic, with prominent nucleoli (arrow) and coarse chromatin. Also seen is evidence of ossification (*).
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F2
On microscopic examination, focal necrosis and multiple foci of osseous metaplasia were noted (Figure 2).