HISTORY:
A man in late 40s presented with complaints of gross hematuria and flank pain.
Non-contrast CT revealed a 7 cm lobulated mass in the anterior aspect of the right kidney and a nonspecific 2.4 cm hypo-attenuated lesion in the right upper lobe of the liver. No significant enlargement of retroperitoneal lymph nodes.
MRI showed heterogeneous lobulated renal mass as well as a liver mass.
GROSS:
A well-circumscribed, irregularly lobulated mass measuring 7.0 x 6.2 x 5.8 cm located in the middle pole of the kidney
Approximately 30% of the mass was necrotic
Invading the renal vein, adherent to the vessel wall
What is the most likely diagnosis?
- Neuroblastoma
- Desmoplastic Small Round Cell Tumor
- Ewing Sarcoma / Primitive Neuroectodermal Tumor
- Lymphoma
Ewing Sarcoma / Primitive Neuroectodermal Tumor