Sandbox: DDx Kidney mass

• 40-50 yo patients
• May have refractory hypertension, palpitations, headache, diaphoresis, anxiety, weight loss, and flank pain
• MEN, von Hippel–Lindau disease, tuberous sclerosis, or neurofibromatosis

• Pallor
• Tachycardia

• Elevated serum catecholamines and metanephrines

• Large, heterogeneous mass on CT
• Areas of necrosis and cystic change
• on CT

• VHL, RET, NF1SDHB and SDHD gene mutation

Nonmalignant causes

anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying