PMC5822868_01
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.
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fig1
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).
Contrast enhanced computed tomography coronal image demonstrates tumoural thrombus within the right renal vein (red arrow).
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fig2
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).
Right kidney with attached ureter showing tumour arising from the renal pelvis projecting into the proximal ureter and infiltrating the renal parenchyma.
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fig3
A low power view of the papillary urothelial carcinoma projecting into the renal pelvis. Carcinoma in situ is present in the adjacent urothelial mucosa.
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Carcinoma in situ involving the adjacent urothelium was noted (Figure 4).
Photomicrograph depicting high grade urothelial carcinoma with transformation to sarcomatoid carcinoma characterized by a spindle cell pattern.
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Higher magnification photomicrograph featuring sarcomatoid component with spindle proliferation, nuclear pleomorphism, and increased mitotic activity.
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Tumour thrombus from the inferior vena cava with high grade urothelial carcinoma and the sarcomatoid component.
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The tumour thrombus from the inferior vena cava was composed of high grade urothelial carcinoma along with the sarcomatoid component (Figure 7).