A rare case of chromophobe renal cell carcinoma in a

55-year-old female : a case report

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 A rare case of chromophobe renal cell
carcinoma in a 55-year-old female : a case
report

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Chromophobe renal cell carcinoma (RCC) is a rare neoplasm of
the kidney, accounting for about 5% of all RCCs. These tumors
generally have a good prognosis. Imaging plays an important role
in the staging and preoperative planning of RCC, as well as for
follow-up. Computed Tomography (CT) is the first choice for
imaging of renal masses, and has been the main stay for several
decades.

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CASE REPORT
A 55-year-old female was admitted in emergency department on July 17th
2019 with complaints of left flank pain for 3 years, short of breathness, and
weight loss. However, no gross hematuria, fever and bowel habit changes
were reported by the patient. An enhanced computed tomography scan on
July 19th 2019 revealed well-circumscribed tumor lesion (approximately 9,4
× 10,8 x 13,4 cm) with heterogeneous enhancement and central necrosis
showing “claw sign” in the lower pole of the left kidney. The mass
deformed the left renal contour (ball-type lesion). The mass also
obliterated the pelvicalyceal system but it didn’t extend to perirenal fascia.
The mass didn’t infiltrate and make thrombus in vascular structure around
it. The patient underwent a left radical nephrectomy and the specimen was
sent to the departement of pathology for histopathological examination.
Histopathology showed tumor cells with pleomorphic nuclei, perinuclear
halos and eosinophilic cytoplasm.

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Non- contrast CT scan of the abdomen

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Non contrast CT scan of the Post contrast CT demonstrates a
abdomen large enhancing left renal mass
CT scan of abdomen shows heterogeneously enhancing mass and
central necrosis (red arrow) at the lower pole of the right kidney
after administration of contrast

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Axial and sagittal contrast - enhanced CT scan of abdomen show a large
mass in the lower pole of the left kidney showing the “claw sign” (red
arrow) around the mass, confirming the renal origin of the mass.

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The mass also obliterated the pelvicalyceal system but it didn’t
extend to perirenal fascia

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Gross photograph of chromophobe renal cell carcinoma
(post radical nephrectomy)

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The tumor typical features of chromophobe RCC with pleomorphic
nuclei, perinuclear halos and eosinophilic cytoplasm.

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Chromophobe RCC is an uncommon subtype of RCC. The most
common clinical symptoms are flank pain, palpable mass and
haematuria. Chromophobe RCC is usually a hypodense mass and
it tends to appear well-circumscribed and homogeneous. It also
includes the presence of a central stellate scar. CT shows TNM
stage T2 N0 tumor.

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CT scan is the first choice for imaging of renal masses as it is the
least complex and most well understood by clinicians. Awareness
of the utility of CT scan in diagnosing these disease might prevent
misdiagnosis and allow for proper tumor management.

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