Residency Program - Case of the Month

Clinical history:

The patient is a 65 year old female who presented with increasing abdominal distention and pain. She denied symptoms of emesis, nausea, diarrhea or constipation. On CTscan she was noted to have a 16.7 x 11.1 x 18.6 cm cystic lesion in the left upper quadrant. Subsequently she underwent left adrenalectomy and nephrectomy.

Gross description:

Gross examination revealed a 1435gm, 23cm mass. It was attached to but did not grossly invade the left kidney. Cut surfaces of the mass were tan-brown to tan-red, lobulated with small foci of golden-yellow-orange tissue scattered throughout. Abundant hemorrhage and necrosis was evident.

Microscopic photographs:

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