WSI23-38

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Request type Study

Subspecialty Genitourinary

Set Genitourinary

Topic Kidney

Presenter Sadow, Peter M.,MD, PhD

Date and time Saturday, April 1, 2023 12:00 PM

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Case	Clinical history	Requester	Diagnosis
Case	Clinical history	Requester	Diagnosis
Case 1	82 year old male with elevated creatinine shown to have left sided hydronephrosis by u/s and f/u CT yielding UPS obstruction and a mass.	Si787	Hybrid oncocytic chromophobe tumor 5.3 cm • mid pole • confined to kidney
Case 2	68 year old man with left 3.5 cm kidney mass	Si787	Clear cell (tubulocystic) papillary renal cell carcinoma. + keratin 7 • + CA 1X-cup-like • - racemase
Case 3	53 year old male s/p Whipple and splenectomy for pancreatitis with kidney mass discovered 2° to ↑ LFTs	Si787	Clear cell renal cell carcnioma 6.2 cm Fuhrman 3/4 + renal vein lymphovascular invasion. pT3a NX
Case 4	72 year old woman with 3.6 cm left kidney mass	Si787	Thyroid-like follicular carcinoma of the kidney ( - TTF1 • - CA1X • - P504S • + PAX8 • - molecular )
Case 5	40 year old woman with left kidney mass	Si787	Epithelioid angiomyolipoma (12.6 cm)+ HMB45 • + MiTF-1 • - Melan A
Case 6	71year old female with stage 4 high grade urothelial carcinoma	Si787	Invasive high grade urothelial carcinoma (Grade 3 of 3) 8.1 cm Right renal pelvis with direct extension to adrenal with + lymph nodes
Case 7	76 year old male with left kidney mass	Si787	Metastatic high grade myxofibrosarcoma morphologically matches priors
Case 8	55 year old female with left cystic renal mass	Si787	Epithelioid clear cell neoplasm suggestive of low grade clear cell renal cell carcinoma
Case 9	73 year old female with right kidney mass	Si787	Renal cell carcinoma with predominantly rhabdoid morphology (4.6 cm). Fuhrman 4. No LVI
Case 10	48 year old male with CAD • drug abuse and OSA who presented with right foot pain found to have bone lesions • mediastinal LAD. B kidney lesions • including 2.4 cm right adrenal nodule. Bx of mediastinal LAD concerig for metastatic renal cell carcinoma	Si787	Renal cell carcioma with clear cell and spindle cell features • multifocal • up to 8.5 cm metastatic to adrenal gland (3.5 cm) + carbonic anhydrase IX
Case 11	85 year old female with renal pelvic mass infiltrating renal parenchymal with purported spread to ipsilateral adrenal gland and retroperitoneal lymph nodes	Si787	Invasive transitinal cell carcinoma • grade 3 of 3 (5.0 cm) ++ fat • ++ angioinvasion
Case 12	65 year old male with left kidney tumor	Si787	Papillary renal cell carcioma • type I • with extensive necrosis and cystic degenerative changes
Case 13	70 year old male with renal stone subsequently found to have a renal pelvis mass	Si787	Transitional cell carcinoma (4.9 cm) grade 3 of 3 with extensive squamous differentiation and lymph node metastases (including distant-neck)
Case 14	38 year old male with left kidney mass and bilateral lung lesions.	Si787	Renal cell carcinoma • clear cell type (4.5 cm) • Fuhrman 2/4. Met RCC to lung.
Case 15	63 year old male with h/o kidney tumor in 2006 and subsequent intraabdominal mass in 2012	Si787	1. Papillary renal cell carcioma • type I (7.9 cm) 2. Malignant mesothelioma.
Case 16	58 year old female with right kidney mass and right adrenal mass • concurrently	Si787	Kidney: Renal cell carcioma • cler cell type (2.5 cm). Fuhrman 1/4 (pTla). Adrenal: Adrenal corticaladenoma (2.6 cm).
Case 17	45 year old male with a complex resection of the left adrenal • kidney • spleen and pancreas	Si787	L kidney: Papillary renal cell carcinoma • type I. L adrenal: metastatic large cellneuroendocrie carcinoma • favor GI primary
Case 18	72 year old male with left renal mass	Si787	Papillary renal cell carcinoma • type I (4.5 cm) • Fuhrman grade 2 of 4
Case 19	24 year old male with Sickle trait • African-American with 8.6 cm left kidney mass and known distant metastases	Si787	Renal medullary carcinoma
Case 20	55 year old male with history of right renal mass with gross involvement of the inferior vena cava • liver and bowel	Si787	Clear cell renal cell carcinoma with rhabdoid and anaplastic morphology (15 cm) Fuhrman grade 4 of 4 with mets
Case 21	45 year old male with left upper tract filling defect	Si787	Urothelial hyperplasia with atypia • favor reactive
Case 22	85 year old with left renal pelvis mass and large superior pole lesion with presumptive adrenal and retroperitoneal mets who presents with hematuria.	Si787	Invasive TCC grade 3 of 3 • arising in association with CIS • pTCC 3/3 with extensive hilar LVI and parenchyma involvement
Case 23	61 year old female with right renal mass	Si787	Chromophobe renal cell carcinoma (5.7 cm) superior pole • confined to kidney
Case 24	73 year old female with right renal mass	Si787	Oncocytoma (2.2 cm)
Case 25	53 year old female with 2 cm mid pole left renal mass and complex 4.9 lower pole mass	Si787	Low grade RCC c/w chromophobe RCC. Other is cystic clear cell
Case 26	49 year old female with left RCC • clear cell • now with right lesion of kidney and abdominal mass	Si787	A. Angiolipoma • focally epithelioid. B. Cystic RCC • clear cell type. C. Angiolipoma
Case 27	61 year old male with exophytic right midpole renal mass with hemorrhage by imaging thought to be a hemorrhagic cyst	Si787	Cystic RCC • clear cell type (5.5 cm). Fuhrman grade 2/4. Two papillary adenomas
Case 28	66 year old morbidly obese male with poorly controlled DM • HT • nodular liver and ~ 10 cm kidney mass	Si787	RCC • clear cell type (9.0 cm) Fuhrman grade 3/4 with LVI and extension into perirenal fat
Case 29	41 year old female with h/o fibrosarcoma of right thigh in 2003 now with mass I right kidney (2.0 cm)	Si787	Chromophobe RCC 2/4 completely excised
Case 30	24 year old female who presented at age 18 with painless lump lateral right knee s/p two resections now with kidney mass	Si787	Metastatic osteosarcoma (10.5 cm) with mixed osteoblastic • fibroblastic and chondroblastic features involving the renal vein
Case 31	80 year old male with right renal mass.	Si787	Renal cell carcinoma • clear cell type (5.2 cm) papillary type I (4.2 cm) with a tubular pattern
Case 32	7 year old male with h/o tuberous sclerosis and polycystic kidney disease	Si787	Papillary renal cell • multiple type II and type I angiolipoma • PCKD (contiguous gene detection syndrome)
Case 33	2 year old Haitian male with 17 cm intraabdominal mass	Si787	Nephroblastoma (Wilms tumor) 17 cm mixed type (intermediate risk)
Case 34	65 year old female who presents with RL pole 2.7 complex • enhancing lesion previously bx with dx	Si787	Papillary renal cell carcioma • type I with extensive necrosis • adrenal cortical nest
Case 35	64 year old female with FNA of inferior kidney pole mass → pap Rcc and 1 cm superior pole mass	Si787	Superior pole → RCC • clear cell type (1.0 cm). Inferior pole atypical oncocytic neoplasm (3.2 cm) with papillary fx (oncocytic papillary RCC vs oncocytoma)
Case 36	61 year old male with mild renal insufficiency discovered to have a 5.5 cm cystic mass on ultrasound	Si787	Renal cell carcinoma • clear cell type with cytic degenerative changes and necrosis
Case 37	64 year old male with left lower pole renal mass (6.0 cm) with 3 additional gross lesions at excision • one (0.6 cm) in upper pole and two in the middle	Si787	Renal cell carcinoma • clear cell type (6.0 cm). Renal cell carcinoma • papillary type I (0.6 cm). Papillary adenomas (two • 0.2 cm each)
Case 38	63 year old male with painless gross hematuria X 2 weeks	Si787	Renal cell carcinoma • cler cell type (7.2 cm). RCC & CD10+ • CK7- • CD117- • TFE 3 focal
Case 39	33 year old female with multiple kidney lesions and a large cyst. Biopsy of one lesion	Si787	Angiomyolipoma
Case 40	2 year old male with large abdominal mass	Si787	Nephroblastoma (17 cm) (Wilms tumor) • mixed type with extensive mesodermal differentiation
Case 41	73 year old male with a 10.5 cm kidney tumor	Si787	Renal cell carcinoma • eosinophilic chromophobe type (10.5 cm) • Fuhrman grade 3 of 4
Case 42	55 year old male with h/o right renal mass with inferior vena cava and liver involvement	Si787	Clear cell renal cell carcinoma with largely rhabdoid and anaplastic-type morphology (15 cm) • Fuhrman grade 4 of 4 • invading the renal vein and IVC. + Liver • + Colon • + IVC
Case 43	1 year old female with left upper pole of kidney ectopic ureterocele	Si787	Consistent with ureterocele renal dysplasia • partial
Case 44	55 year old male with right upper pole kidney mass.	Emw8	Chromophobe renal cell carcinoma 8.1 cm.