PMC9448560_01
Contrast sagittal section shows a large hematoma at the left retroperitoneal region (blue arrow), the normal-appearing left kidney (thin red arrow), and an exophytic left upper pole renal mass (red arrowhead).
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Subsequent computed tomography (CT) of abdomen and pelvis showed an exophytic upper pole cortical mass (red arrowhead) in the left kidney (red arrow) measuring 7 x 4.5 x 7.3 cm in transverse, anterior-posterior, and craniocaudal diameter, respectively (Figure 1).
Contrast axial view section shows an ill-defined margin between the exophytic mass and the kidney (curved yellow arrow).
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An axial image showed an ill-defined margin between the mass and the kidney denoted by a curved yellow arrow (Figure 2).
Green arrow shows a contrast extravasation consistent with active bleeding.
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A focal rounded area of intense enhancement (green arrow) was seen on arterial phase images consistent with active low-intensity bleeding (Figure 3).
Postoperative left nephrectomy specimen with evacuated 3.5 L blood and clots.
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The patient was then scheduled for surgery, which included a left nephrectomy with complete mass excision, and a total of 3.5 liters of blood and clots were removed from the peritoneum (Figure 4).
Gross anatomy specimen showing the exophytic renal cortical tumor incontinuity with the renal cortex (black arrow).
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Gross anatomy specimen is kidney with attached tumor size of 7 cm (Figure 5).
On low magnification, the left side shows normal-looking renal tubules and the right side shows the fatty tissue with round blue cells consistent with tumor cells.
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Histology: on low magnification, the left side shows normal-looking renal tubules and the right side shows the fatty tissue with round blue cells consistent with tumor cells (Figure 6).
On high magnification, remarkable cellularity, granular cytoplasm, and central or slightly eccentric nuclei are observed. There are no abnormal mitosis and mild nuclear pleomorphism.
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No cellular spindling or necrosis was seen (Figure 7).