Endophytic renal cell carcinoma mimicking urothelial neoplasm of the pelvicalyceal system: A prime surgical concern

Centrally infiltrating renal mass poses great diagnostic and therapeutic challenge for both radiologist and urologist. It is often practically impossible to dedifferentiate on imaging and will render patients to receive unnecessary aggressive surgery. Here we have presented such case for its utmost importance in the clinical settings and reviewed with the available literature. A 70-year-old female was preoperatively diagnosed having right intrarenal transition cell carcinoma, stage T 3 N 0 M 0 . Accordingly, she underwent right nephroureterectomy and the specimen was sent for histopathological examination that revealed an eosinophilic variant of chromophobe renal cell carcinoma (EVCRCC). Biologically it is a tumor of low malignant potential and therefore, in spite of nephroureterectomy, only nephrectomy or a more minimally invasive procedure is the ideal treatment. Henceforth, caution must be exercised while treating such entity and in uncertainty, we may consider a quick pre-operative image-guided percutaneous renal biopsy.