HISTORY:
A male in his 20’s with history of HTN, DM, obesity, OSA and GERD.
He presented with complaints of scrotal pain and underwent CT scan for concerns for kidney stones.
CT scan showed hyperdense mass of the lower pole of left kidney measuring 2.6 cm, soft tissue mass just medial to the right renal hilum measuring 2.7 cm, possibly enlarged node with hepatic steatosis.
Scrotal US was negative for testicular masses.
Repeat CT with and without IV contrast showed left renal inferior pole 2.8 cm mass, suspicious for primary renal neoplasm with enlarged right retroperitoneal 'lymph node' measuring 2.5 cm in short axis, suspicious for metastatic disease.
The patient underwent left robotic partial nephrectomy and biopsy of retroperitoneal lymph node.
Genetic testing results were positive for a mutation in one copy of the SDHB gene. His mother also noted to have an SDHB germline mutation.
GROSS:
The slides of the specimen came as a consult case from the genitourinary oncology department at The Ohio State University.
Outside, received as two cores of red-tan soft tissue piece, up to 1.0 x 0.1 x 0.1 cm.
What is the most likely diagnosis?
- Paraganglioma of the bladder
- Transitional Cell Carcinoma
- Neurogenic Bladder
- Renal Cell Carcinoma
Paraganglioma of the bladder