Date of Presentation:9/22/2021

Attending pathologist: Anil Parwani, MD, PhD, MBA

Presented by: Nermeen Chaudhry, BA

Prepared by: Nada Shaker, MD

Organ:Kidney

HISTORY:

A 48 year old male with history of GERD, hypertension, Wolff-Parkinson-White syndrome ablation, and a VP shunt secondary to hydrocephalus presented for evaluation of a left renal mass found incidentally during a previous MRI. A follow up MRI of the abdomen revealed a left lower pole 1.6 cm enhancing renal mass concerning for renal cell carcinoma. A partial nephrectomy was performed.

GROSS:

Serial sectioning of the specimen reveals a 1.5 x 1.4 x 1.1 cm well-circumscribed, rubbery mass with tan-pink, homogeneous, solid cut surfaces that is less than 0.1 cm from the capsular surface and 0.2 cm from the renal parenchymal margin.  

The mass is limited to the kidney and does not appear to involve the perinephric fat. The surrounding uninvolved renal parenchyma is tan, rubbery, and exhibits significant pallor.

What is the most likely diagnosis?

  1. Renal angiomyoadenomatous tumor
  2. Clear cell papillary renal cell carcinoma
  3. Renal cell carcinoma with leiomyomatous stroma
  4. Papillary renal cell carcinoma
Renal cell carcinoma with leiomyomatous stroma