| 75 years old patient, incidentally diagnosed by routine ultrasound of a solid mass in the upper pole of the right kidney. | |
| A year and a half later he came to our consultation. | |
| He had not followed any treatment. | |
| She remains asymptomatic. | |
| radiological findings | |
| Thoracic PA and L: calcified adenopathies in mediastinum, presence of some isolated fibrous tract in left base. | |
| Abdominal CT: at the level of the upper pole of the right kidney and in an internal situation, a solid mass of about 5 cm is observed, in its growth down, it touches the renal sinus, growing behind the vascular structures. | |
| 1. | |
| After contrast administration, intense uptake was observed, highlighting the presence of a central scar. | |
| The contours are clear and the encapsulated mass appears with respect to the renal parenchyma. | |
| There were no signs of involvement of the renal vein, extension to the perirenal space or lymphadenopathy. | |
| In conclusion, renal mass to be determined, although with onychoma. | |
| Bone scintigraphy: increased uptake deposits at the level of the 5th lumbar vertebra, and another at the cervical level, compatible with osteodegenerative processes. | |
| Treatment and conservative management: with presumptive diagnosis of localized renal adenocarcinoma, right upper partial nephrectomy was performed. | |
| Intraoperative diagnosis qualifies the tumor as clear cell adenocarcinoma and indicates free resection margins (T1G1). | |
| However, the definitive pathological anatomy report states that 'renal tumor has an apparently thyroid differentiation. | |
| Immunohistochemical studies seem to confirm the thyroid origin of the tumor, since antithyroglobulin, vimentin, AE3-AE1, CAM5.2, alpha1 antitrypsin, calcitonin have been used in antitrypsin. | |
| Cells are positive for antithyroglobulin, CAM5.2 and S-100'. | |
| The patient refused to perform complementary examinations and immediate treatments, but at 4 months she began with dysphonia and foreign body sensation in the neck. | |
| The cervicothoracic CT scan showed a mass in the left thyroid lobe of 5-3-6 cm, with growth to the superior mediastinum, with involvement of the thyroid isthmus, adenopathies of 1 cm in diameter in group y. | |
| Total thyroidectomy and left functional lymph node dissection were performed, as well as total laryngectomy due to local invasion of the neoplasm. | |
| The pathology report confirmed the existence of a poorly differentiated thyroid follicular carcinoma. | |
| A complementary session with ablative dose of iodine-131 is performed. | |