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An unusual renal mass

BMJ 2006; 333 doi: (Published 01 July 2006) Cite this as: BMJ 2006;333:0607280
  1. Balakrishnan Saravanan, senior house officer1,
  2. Siddharth Neminathan, senior house officer2,
  3. Kevin J Thomas, consultant urologist3
  1. 1Department of Urology, Ysbyty Gwynedd
  2. 2Department of Urology, Ysbyty Gwynedd
  3. 3Department of Urology, Ysbyty Gwynedd

A woman aged 52, otherwise fit and well, was admitted as an emergency with the history of a sudden onset constant back pain on the right hand side, for the past four hours.

On examination her vital signs were blood pressure: 130/78 mm Hg; pulse 80/minute.

Abdominal examination was unremarkable, except for mild tenderness in the right renal angle. All blood investigations including inflammatory markers and liver function tests were within normal limits, with a haemoglobin of 12×10 g/l. The haemoglobin suddenly dropped to 8×10 g/l a day after admission. The patient was stabilised with fluid resuscitation and blood transfusion. She had an ultrasound scan of the abdomen (fig 1) and subsequently a computed tomography scan (fig 2).

Fig 1

Ultrasound scan of abdomen

Fig 2

Computed tomography scan of abdomen


  1. What do the ultrasound and computed tomography scans show?

  2. What is the incidence, mean age, and sexual distribution of this condition, and does it affect one side more than the other?

  3. Name two conditions associated with it.

  4. What procedure does the images below show?


  1. The ultrasound shows a highly echogenic tumour in the right kidney, due to high fat content, and the computed tomography scan shows a heterogeneous tumour predominantly of fat density, both suggesting the …

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