This case highlights the prudent use of imaging and management approach in this group of tumors, so that adequate treatment strategies can be made preoperatively. The authors are presenting few observations based on retrospective analysis of imaging and intra-operative finding of this diagnostic dilemna. It was determined only at histopathology examination of the resected tumor specimen. The origin of the mass was virtually indistinguishable on imaging and intraoperatively. We report the clinical presentation, imaging findings, intra-operative appearance and pathological results of an exophytic renal cell carcinoma (RCC) of the upper pole of kidney which was presumed to arise from the ipsilateral adrenal gland.
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