PMC7034944_01
Representative MRI images showing the 20.3 x 12.6 x 10.6cm, with both solid and cystic components
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F1
Further evaluation with an abdominal MRI confirmed the presence of a right renal mass, measuring 20.3 x 12.6 x 10.6cm, with both solid and cystic components (Figure 1).
Sheets of monotonous small round blue cells with scant cytoplasm, hyperchromatic nuclei and inconspicuous nucleoli (A) under low magnification (20x) with adjacent renal parenchyma, and (B) under higher magnification (200x). The tumor shows strong (C) membrane staining for CD99 (200x) and (D) nuclear staining for FLI-1 (200x).
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F2
Proton Beam Therapy treatment fields to both the lungs and right flank area, including the resection bed.
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F3
In efforts to minimize any overlap between the flank radiation and WLI, as well as minimizing secondary effects of radiotherapy, he was treated with proton beam therapy (PBT) to the flank (Figure 3).