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Patient: Male, 17-year-oldFinal Diagnosis: GanglioneuromaSymptoms: IncidentalMedication: —Clinical Procedure: CT scanSpecialty: RadiologyObjective:Unusual clinical courseBackground:Ganglioneuroma is a rare benign sympathetic chain neoplasm which rarely arise from the adrenal gland in adults and exceedingly rare for ganglioneuroma to arise from different origins in the same patient. We present a rare case of retroperitoneal ganglioneuroma concurring with an adrenal ganglioneuroma in an adult patient.Case Report:A 17-year-old healthy male underwent computed tomography (CT) scan after road traffic accident where he was found to have a left adrenal homogeneous hypovascular lesion with another retroperitoneal lesion seen within the right para-colic gutter with similar radiological features. Successful surgical resection was obtained, and histological diagnosis of both lesions was benign ganglioneuroma.Conclusions:Adrenal and extra-adrenal ganglioneuroma can, although rare, concur together. Key findings are the similar radiological appearance of the lesions with typical hypovascular progressive pattern of enhancement. Appropriate pre-surgical diagnosis can aid to proper management since ganglioneuroma needs wide surgical resection due to its high chance of recurrence.

Patient: Male, 28 Final Diagnosis: Cystic chromophobe rcc Symptoms: Flank pain Medication: — Clinical Procedure: Ct scan Specialty: Radiology Objective: Rare disease Background: Chromophobe renal cell carcinoma is a rare subtype of renal cell carcinoma which accounts for 4% to 6% of renal cell carcinoma subtypes. These tumors generally have a good prognosis. Typical radiological features include a well-defined homogeneous mass and a hypo-vascular soft tissue enhancement. Cystic chromophobe renal cell carcinoma is a very rare entity in which the overall estimated cystic renal cell carcinoma of all subtypes account for 4%. We describe a rare presentation of chromophobe renal cell carcinoma presenting as a unilocular cystic mass with mural nodules. Case Report: A 28-year-old healthy male presented with a history of right upper quadrant fullness and discomfort. Hepatomegaly was expected on examination. Ultrasonographic assessment revealed a normal liver size and echo texture. However, a large cystic mass measuring 15.7×12.8 cm was found arising from the right kidney which showed no internal vascularity but turbid fluid and debris within the dependent regions of the mass. Multiphase computed tomography scan showed a large unilocular cystic mass with enhancing mural nodules. There was no lymphovascular or perirenal invasion. The patient underwent uneventful total right renal nephrectomy. Histological examination revealed a chromophobe renal cell carcinoma of grade II. Conclusions: Cystic renal neoplasm differential diagnosis varies from benign entities to malignant neoplasms. Knowledge of the variable common features for each renal cell carcinoma subtypes can aid in narrowing the differential diagnosis and prompt appropriate surgical management since a possibility of nephron sparing technique might still take place in suspected cystic chromophobe renal cell carcinoma but never for cystic clear cell renal cell carcinoma.

Key Clinical MessageWe document the rare occurrence of multiple primary benign lesions that can occur in bilateral ovarian masses with benign imaging appearances and tumor markers. In addition, this case report contributes important information that may aid physicians in guiding their patients to make optimal clinical decisions together.