HISTORY:
                    male in their 60’swith a Positive Family History of Kidney Cancer (paternal grandmother)
                    Presented for lower back pain with sciatica and right hip pain
                    Outside MRI abdomen revealed a left upper renal 2.7 x 2.7 cm mass
                    No definitive evidence of metastatic disease in the kidney, abdomen or chest
 
                    Presents to OSUMC for Left Nephrectomy
                 
                 
                   GROSS:
                     Left Renal Mass with Perinephric Fat
                     Sectioning reveals a 3.4 x 2.7 x 2.3 cm tan-pink, solid, rubbery mass with central hemorrhage (20%) without necrosis or calcification
                     There is a scant amount of uninvolved renal parenchyma which appears tan, homogeneous, unremarkable
 
                
                  
                
                
                
                
                
                 
                 
                 
                  
                 
                 
               
                         
                
                 
               
                 
                  
                
                    
                 
                            What is the most likely diagnosis?
                            
                                - Papillary Renal Cell Carcinoma
 
                                - Nephroblastoma
 
                                - Metanephric Adenoma
 
                                - Metanephric-like ALK-rearranged renal cell carcinoma