Gross Description -- A Large Mass in the Right Kidney


The patient underwent a radical right nephrectomy. The specimen consisted of a large edematous appearing native kidney, 780 grams and 23.0 x 15.0 x 6.5 cm. Bisection of the kidney revealed an irregular mass, 13.0 x 10.0 x 5.5 cm., with a heterogenous appearing bulging cross-cut surface contained a central 6.0 x 4.0 x 5.5 cm. triangular white to yellow area containing gelatinous friable tissue immediately surrounded by areas of firm, shiny, white tissue. Located more peripherally were areas of hemorrhage. The mass appeared well circumscribed and compressed the remaining normal renal parenchyma, which consisted of a triangular-shaped 6.0 x 4.0 cm. portion of parenchyma within the superior pole and a 5.0 x 4.0 cm. oval-shaped portion of parenchyma within the inferior pole. Within these regions, the renal parenchyma had scattered firm, glistening white and soft, focally firm, shiny yellow nodules. The tumor mass invaded the renal capsule but the perinephric fat, Gerota's fasciae, vascular resection margins, ureter, and adrenal gland, 5.5 x 3.5 x 1.2 cm., were grossly free of tumor. Perinephric lymph nodes were identified and on sectioning contained firm homogeneous tan parenchyma with focal areas of hemorrhage.




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