Clear Cell Renal Cell Carcinoma Involving Intrarenal Adrenal Tissue: A Rare Case With Staging Implications.

The presence of intrarenal adrenal tissue is a rare finding that complicates the staging of renal cell carcinoma, particularly in distinguishing between adrenal-renal fusion and ectopic adrenal remnants. These conditions, though rare, have unique implications for tumor staging and management. We present a case of a 47-year-old woman with a lesion of the right kidney incidentally discovered during imaging for ulcerative colitis. Histopathology revealed clear cell renal cell carcinoma infiltrating adrenal tissue confined to the kidney capsule, with no lymphovascular or perirenal fat invasion. Radiologic correlation indicated ectopic rather than fused adrenal tissue. Failure to correctly classify the presence of adrenal involvement could result in incorrect staging of the carcinoma, highlighting the importance of integrating histopathologic and radiologic findings in accurate diagnosis and management.