Photo Rounds

Left-sided flank pain

A 56-year-old man with hypertension presented to his physician with a 2-week history of left-sided flank pain. Urinalysis showed microscopic hematuria. A computed tomography (CT) scan with and without contrast was ordered.

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The CT scan revealed a solid left renal mass; a biopsy confirmed renal cell carcinoma (RCC). A subsequent workup for metastatic disease was negative.

Renal tumors are a heterogeneous group of kidney neoplasms derived from the various parts of the nephron. Each type of tumor possesses distinct genetic characteristics, histologic features, and to some extent, clinical phenotypes that range from benign (approximately 20% of small masses) to high-grade malignancy. Up to 95% of kidney neoplasms are RCCs.

For localized disease, partial nephrectomy for small tumors and radical nephrectomy (complete removal of the kidney and Gerota fascia) for large tumors is the gold standard. This patient underwent a radical nephrectomy without complications.

Photo courtesy of Michael Freckleton, MD, and text courtesy of Richard P. Usatine, MD. This case was adapted from: Smith, M. Renal cell carcinoma. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:441-447.

To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: http://usatinemedia.com/

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