Table 1 Timeline showing pertinent procedures and findings

July 03, 2012: US of the kidneys and pelvis revealed left kidney heterogeneous hyperechoic lesion. Further evaluation (18 July 2012) by triphasic CT showed a Bosniak type 2 renal cyst.

10 May 2014: Admitted for urinary symptoms, enlarged scrotal sac.

12 May 2014: US of the testicles revealed right epididymo-orchitis with reactive inflammatory hydrocele. Lesion containing calcifications within the tail of the right epididymis possibly representing an adenomatoid tumor.

14 May 2014: US of the abdomen and pelvis revealed hyperechoic lesion within the superior aspect of the left kidney slightly increased in size. Further evaluation via a dedicated MRI examination recommended.

17 May 2014: MRI of the abdomen showed multiloculated cystic mass within the midpole of the left kidney. Cystic renal cell carcinoma was the most likely diagnosis.

6 June 2014: PET scan showed a well-defined hypodense lesion involving the anterior aspect of the left kidney measuring 4.3 × 3.3 cm and showing diffusely low activity (SUV_max 2.2) with a focus of increased activity along its superior anterior aspect with an SUV_max of 2.9 on the early phase and an SUV_max of 3.2 on the delayed phase.

19 November 2014: MRI the abdomen with gadolinium showed an interval increase in the size of the left kidney lesion measuring 4.7 × 5.2 cm (previously 3.9 × 4.7 cm). The mass again showed extension to the renal hilum.

21 November 2014: US of the testicles showed a decrease in the lesion in the right epididymal tail, showing some calcifications. This lesion can represent an adenomatoid tumor

Reactive right hydrocele and right small spermatocele or epididymal head cyst were noted.

2 April 2015: Partial left nephrectomy.

16 April 2015: Immunohistochemistry and microscopic findings revealed tubulo-cystic renal carcinoma with free surgical margins.

15 October 2024: Patient functional, assuming an advisorship position in a university.