Patient History

A 46-year-old woman presenting with dysuria, pyuria, frequency, and lumbar back pain was diagnosed with pyelonephritis from an ascending E. coli urinary tract infection. The patient had been recently diagnosed with breast cancer, and was treated with a modified radical mastectomy, axillary node dissection, followed by adjuvant chemotherapy. None of the lymph nodes in the axillary dissection were involved by cancer.

A CT scan of the abdomen and pelvis showed a very large right kidney with a right upper pole renal mass with central necrosis and hemorrhage. A biopsy was consistent with renal cell carcinoma. A repeat abdominal MRI showed a moderately complex cystic lesion at the upper pole of the right kidney with a vascularized rim of soft tissue. A right partial nephrectomy was performed