High-Resolution Ultrasonography of Renal Oncocytoma Presenting with Symptomatic Hematuria and Urinary Bladder Clot Retention—A Rare Occurrence

Ravikanth Reddy

doi:10.15586/jkcvhl.v9i1.200

Abstract

Renal oncocytomas are asymptomatic, benign tumors often encountered incidentally on various imaging modalities. Renal oncocytomas comprise 5–7% of primary renal neoplasms and are derived from cells of the distal renal tubule. We present a case report of renal oncocytoma in a 22-year-old male having right-sided flank pain and symptomatic gross hematuria with a giant urinary bladder clot retention. The tumor was excised, and the patient underwent laparoscopic partial nephrectomy. Typical features of renal oncocytoma were observed upon histopathological examination of the resected specimen. The patient was catheterized, and bladder irrigation with clot retraction was performed.

Highlights

Renal oncocytoma was first described by Zippel in 1942 as a benign tumor of the renal parenchyma (1)
Definitive preoperative diagnosis of renal oncocytoma is challenging as laboratory and clinical findings usually reveal no specific characteristics of the entity
Renal oncocytoma should be included in the differential diagnosis of solid renal mass lesions discovered incidentally or tumors located within a solitary kidney

Summary

Introduction

Renal oncocytoma was first described by Zippel in 1942 as a benign tumor of the renal parenchyma (1). Most cases of renal oncocytoma are discovered only incidentally during routine imaging evaluation of nonurological problems and are often asymptomatic at presentation, but flank pain, hematuria, and a palpable mass may be encountered in a minority of documented cases. The variable nature of presentation and overlap of radiological findings between renal oncocytoma and RCC may often complicate their clinical differentiation. The patient was referred to the Department of Radiology for ultrasonography of the abdomen which revealed a well-circumscribed, heteroechoic, cortical based lesion measuring 2.0 × 1.8 cm located in the upper pole of right kidney. Based on the radiological findings, a diagnosis of renal oncocytoma with symptomatic hematuria leading to giant clot retention in the urinary bladder was made. The patient has given written informed consent to publish his case and clinical images

Discussion

Findings

Conclusion

Ethical Approval