1. Presented by Peter Illei, M.D. and prepared by Joseph J. Maleszewski, M.D.

43-year-old retired housewife who reports approximately 5- month history of right flank, right CVA pain. This pain is now shifted and she now has intermittent periods of radiation down her back with accompanying numbness. She recently noted gross hematuria in 03/08 that and was given antibiotics for urinary tract infection. The hematuria resolved; however, the pain persisted. This prompted evaluation with the CT scan that demonstrated a kidney mass with involvement of the inferior vena cava.

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