CASE OF A LARGE RENAL ONCOCYTOMA AND DIAGNOSTIC CHALLENGES ENCOUNTED ntiamoaheffah@yahoo.com

PE072

CASE OF A LARGE RENAL ONCOCYTOMA AND DIAGNOSTIC CHALLENGES ENCOUNTED

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Ghana

Oral only

Renal oncocytomas are uncommon benign kidney tumors making up about 5–7% of all primary renal neoplasms. They arise from the intercalated cells of the collecting ducts and are often discovered incidentally. Their clinical and radiological features closely mimic renal cell carcinoma, creating significant diagnostic challenges. This case illustrates one such challenge where diagnosis was confirmed only after radical nephrectomy.

case report

We describe a 28-year-old woman who noticed a painless swelling in her right flank, which she discovered by self-examination a year prior. She had a history of non-steroidal anti-inflammatory drug (NSAID) abuse and was a secondary smoker. On examination, a mildly tender mass measuring 13 x 11 cm was found in the right flank extending into the lumbar area. Abdominal Computed Tomography imaging revealed a well-defined, heterogeneously enhancing exophytic lesion (9.9 x 7.3 x 9.0 cm) with calcifications arising from the interpolar region of the right kidney, Bosniak IV. The patient declined preoperative biopsy, citing she couldn’t bare the trauma of multiple procedures since surgery was already planned. She underwent a radical right nephrectomy, which revealed a 554 g renal tumor without evidence of lymph node involvement and vascular invasion. Histology and immunohistochemistry confirmed a renal oncocytoma. She has since remained well, with normal renal function and no sign of metastasis.

Although not the largest oncocytoma reported in Ghana, this case demonstrates a significantly large lesion. Renal oncocytomas, while benign, can mimic malignancy, underscoring the need for careful evaluation and individualized surgical decisions to avoid overtreatment.