A 36-year-old man consulted for chronic diarrhoea and weight loss.
An analytical study was performed, consisting of general biochemistry, haemogram, TSH, immunological study, celiac profile and stool parasites, which was normal. C-reactive protein was elevated. Colonoscopy was performed up to the cecum, which was normal, and no abnormalities were identified in the barium intestinal transit.
Abdominal ultrasound showed a left renal mass in the upper pole measuring more than 4 cm in diameter, rounded, isoechoic with hypoechoic areas inside that could be compatible with necrotic areas.

The CT scan confirmed the existence of this 4.3 cm lesion, hypodense, limited to the kidney, without affecting the perirenal fat or the vascular pedicle. The patient was referred to the urology department and underwent laparoscopic left nephrectomy, with macroscopic visualisation of a lobulation in one of its poles, with an intact Gerota's capsule and no other significant macroscopic alterations. In the sections, a rounded, well-defined lesion measuring 4.8 x 4.5 cm was identified at this pole, with yellowish, brownish parenchyma, with small millimetric cavities and friable to the cut, being very close to the renal capsule. A diagnosis of Delahunt and Eble type 2 papillary renal cell carcinoma was made. The patient is currently asymptomatic, with the diarrhoeic symptoms for which he consulted having subsided after the operation.