09/15/2026
Can you determine the pathologic stage?
An adult male with an upper pole renal mass undergoes radical nephrectomy. Grossly, the tumor encroaches into the adjacent adrenal gland, which is also resected.
Review the images and make your call. Answer at the bottom of this post.
This case was submitted by Ankur Sangoi, MD, Course Director for USCAP’s upcoming Interactive Microscopy course, An Inside Peek Into the GU Consult Vault: Problematic Consultation Cases and How We Approach Them, September 30–October 2 at USCAP’s Interactive Center.
Learn more: https://buff.ly/nDuuSWQ
Answer: pT3a (perinephric fat invasion)
The tumor abuts but does not directly invade the adrenal gland, so this is not pT4. However, polypoid extension through the renal capsule into the perinephric fat is present, supporting pT3a.