{"id":7563,"date":"2022-10-25T10:23:30","date_gmt":"2022-10-25T10:23:30","guid":{"rendered":"https:\/\/iboblr.in\/gupathsociety\/?page_id=7563"},"modified":"2022-10-28T08:00:54","modified_gmt":"2022-10-28T08:00:54","slug":"cow-2022-38","status":"publish","type":"page","link":"https:\/\/iboblr.in\/gupathsociety\/cow-2022-38\/","title":{"rendered":"cow-2022-38"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7563\" class=\"elementor elementor-7563\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-51fa437 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"51fa437\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c1c9ed2\" data-id=\"c1c9ed2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4d0e711 elementor-widget elementor-widget-html\" data-id=\"4d0e711\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<script>\r\njQuery(document).ready(function($) {\r\nvar delay = 100; setTimeout(function() {\r\n$('.elementor-tab-title').removeClass('elementor-active');\r\n $('.elementor-tab-content').css('display', 'none'); }, delay);\r\n});\r\n<\/script>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-102e190 elementor-widget elementor-widget-heading\" data-id=\"102e190\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">CASE OF THE WEEK<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-821786a elementor-widget elementor-widget-text-editor\" data-id=\"821786a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Editor:&nbsp;Mahmut Akgul (<a href=\"https:\/\/mail.google.com\/mail\/?view=cm&amp;fs=1&amp;tf=1&amp;to=akgulm@amc.edu\" target=\"_blank\" rel=\"noopener\">akgulm@amc.edu<\/a>)<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-449ce5a elementor-widget elementor-widget-text-editor\" data-id=\"449ce5a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>2022-38\/October 3<\/strong><\/p><p><strong>Contributors: Jaime Eberle-Singh, Sherry Lee, Li Li<\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d0d5e22 elementor-widget elementor-widget-text-editor\" data-id=\"d0d5e22\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tA woman in her early 70s was incidentally found to have a 4.5 cm right upper pole renal mass on imaging (Figure 1A). She underwent a right partial nephrectomy.\n\nCLICK ON THE BELOW THUMBNAILS TO ENLARGE PHOTOS.\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f09504c elementor-widget elementor-widget-heading\" data-id=\"f09504c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Quiz<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae2d831 elementor-arrows-position-inside elementor-pagination-position-outside elementor-widget elementor-widget-image-carousel\" data-id=\"ae2d831\" data-element_type=\"widget\" data-settings=\"{&quot;navigation&quot;:&quot;both&quot;,&quot;autoplay&quot;:&quot;yes&quot;,&quot;pause_on_hover&quot;:&quot;yes&quot;,&quot;pause_on_interaction&quot;:&quot;yes&quot;,&quot;autoplay_speed&quot;:5000,&quot;infinite&quot;:&quot;yes&quot;,&quot;speed&quot;:500}\" data-widget_type=\"image-carousel.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! 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elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-accordion{text-align:left}.elementor-accordion .elementor-accordion-item{border:1px solid #d4d4d4}.elementor-accordion .elementor-accordion-item+.elementor-accordion-item{border-top:none}.elementor-accordion .elementor-tab-title{margin:0;padding:15px 20px;font-weight:700;line-height:1;cursor:pointer;outline:none}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{display:inline-block;width:1.5em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon svg{width:1em;height:1em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-right{float:right;text-align:right}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-left{float:left;text-align:left}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-closed{display:block}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-opened,.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-closed{display:none}.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-opened{display:block}.elementor-accordion .elementor-tab-content{display:none;padding:15px 20px;border-top:1px solid #d4d4d4}@media (max-width:767px){.elementor-accordion .elementor-tab-title{padding:12px 15px}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{width:1.2em}.elementor-accordion .elementor-tab-content{padding:7px 15px}}<\/style>\t\t<div class=\"elementor-accordion\" role=\"tablist\">\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5781\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"tab\" aria-controls=\"elementor-tab-content-5781\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">1. What is the correct diagnosis?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5781\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5781\"><p>a) Renal neurofibroma<\/p><p>b) Angiomyolipoma<\/p><p>c) Sarcomatoid renal cell carcinoma<\/p><p>d) Renal leiomyoma<\/p><p>e) Leiomyoma<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5782\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"tab\" aria-controls=\"elementor-tab-content-5782\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Quiz Answers<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5782\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5782\"><p>1. d<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5783\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"tab\" aria-controls=\"elementor-tab-content-5783\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Diagnosis<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5783\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5783\"><p>Renal leiomyoma<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5784\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"tab\" aria-controls=\"elementor-tab-content-5784\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Discussion<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5784\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5784\"><p>This 4.5 cm right upper pole renal mass was well-circumscribed and had homogenous tan-white whorled cut surfaces without necrosis (Figure 1B). Microscopic examination revealed that the lesion arose from the renal capsule (Figures 1B &amp; 2). Spindle cells were present in an orderly fascicular growth pattern interspersed with stroma. The cytoplasm was eosinophilic and nuclei were cigar-shaped and bland, without mitoses or atypia (Figure 2 inset). On immunohistochemical evaluation, lesional cells were positive for alpha-smooth muscle actin (SMA) and desmin, and negative for cytokeratin AE1\/AE3, S-100, HMB45, neurofilament protein, beta-catenin, CD34, and DOG-1. Ki-67 staining showed less than 1% proliferation and in situ hybridization (ISH) for EBER was negative (Figure 3). These findings are consistent with the diagnosis of renal leiomyoma.<br \/><br \/>Renal leiomyomas are rare benign mesenchymal tumors that usually arise in the renal capsule or renal pelvis. It is currently estimated that renal leiomyomas account for less than 1% of treated renal neoplasms. While these tumors were previously identified primarily on autopsy, more frequent medical imaging has led to increased incidental identification and treatment of these typically asymptomatic lesions. Occasionally, a large renal leiomyoma will present due to mass effect. Other symptoms may include a palpable flank mass, flank pain, or hematuria. They are found more frequently in adult women, possibly due to the expression of estrogen and progesterone receptors in a high proportion of these tumors. Despite this association, the cause of renal leiomyomas is not well understood. Previous reports have identified associations with Epstein-Barr Virus and tuberous sclerosis, but more investigation of the etiology of renal leiomyomas is needed.<br \/><br \/>While the differential diagnosis for renal leiomyoma can broadly include all benign and malignant renal spindle cell neoplasms, three important tumors to consider in the differential are leiomyosarcoma, sarcomatoid renal cell carcinoma (sRCC), and lipid-poor angiomyolipoma (AML). Leiomyosarcoma is the malignant counterpart of leiomyoma and can be distinguished by cytologic atypia (nuclear heterogeneity and abnormal mitotic figures), tumor necrosis, and increase in proliferation. It is also important to differentiate renal leiomyoma from sRCC, which is a rare dedifferentiation process that can occur in any subtype of RCC and carries a very poor prognosis. Similar to leiomyosarcoma, this lesion can often be ruled out based on the presence of residual carcinoma, tumor cellular atypia, high mitotic rate, and necrosis. Further confirmation is provided by immunohistochemistry, with sRCC typically staining positive for AE1\/AE3 and negative for SMA and desmin. Lipid poor AML should also be ruled out, as renal leiomyoma has frequently been misclassified as this similar-appearing benign mesenchymal tumor. These tumors are composed of varying proportions of spindle and epithelioid smooth muscle cells, thick-walled blood vessels, and adipose tissue. Lipid-poor AMLs, particularly those that are enriched with spindle-shaped smooth muscle cells, have historically been misclassified as leiomyomas. Both AMLs and leiomyomas express smooth muscle markers; however, they can be distinguished with either HMB-45 or cathepsin K. AML should show co-expression of HMB-45 and\/or cathepsin K with smooth muscle markers, while leiomyomas stain negative for HMB-45 and cathepsin K.<br \/><br \/>The prognosis of renal leiomyoma is excellent. Small leiomyomas can be treated with biopsy and surveillance. Large tumors are typically resected. Once the tumor is removed, it should not recur unless resection was incomplete.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5785\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"tab\" aria-controls=\"elementor-tab-content-5785\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">References<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5785\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5785\"><p>Blum KA, Gupta S, Tickoo SK, et al. Sarcomatoid renal cell carcinoma: Biology, natural history, and management. Nature Reviews Urology. 2020 Oct;17:659-678.<br \/><br \/>Brunocilla E, Pultrone CV, Schiavina R, et al. Renal leiomyoma: Case report and literature review. Canadian Urological Association Journal. 2012 Apr;6(2):87-90.<br \/><br \/>Chaniotakis S, Yang Y, Patel T, et al. Large renal leiomyoma: A multidisciplinary approach to diagnosis. J Radiol Case Rep. 2021 Aug;15(8):18-26.<br \/><br \/>DiPalma, S &amp; Giardini, R. Leiomyoma of the kidney. Tumori. 1988 Aug;74(4):489-493.<br \/><br \/>Fu L, Humphrey PA, &amp; Adeniran AJ. Renal leiomyoma. The Journal of Urology. 2015 Mar;193(3):997-998.<br \/><br \/>Krishnan R, Freeman JA, &amp; Creager AJ. Epstein-Barr virus induced renal leiomyoma. The Journal of Urology. 1999 Jan;161(1):212.<br \/><br \/>Magi-Galluzzi C, Billings SD, &amp; McKenney JK. Leiomyoma. In: WHO Classification of Tumours Editorial Board. Urinary and male genital tumours [Internet]. Lyon (France): International Agency for Research on Cancer; 2022 [cited 2022 Aug 6]. (WHO classification of tumours series, 5th ed.; vol. 8). Available from: https:\/\/tumourclassification.iarc.who.int\/chapters\/36.<br \/><br \/>Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells: Problems is histological diagnosis. Histology. 2002 Jan;33(1):20-27.<br \/><br \/>Patil PA, McKenney JK, Trpkov K, et al. Renal leiomyoma: A contemporary multi-institution study of an infrequent and frequently misclassified neoplasm. The American Journal of Surgical Pathology. 2015 Mar;39(3):349-356.<br \/><br \/>Romero FR, Kohanim S, Lima G, et al. Leiomyomas of the kidney: Emphasis on conservative diagnosis and treatment. Urology. 2005 Dec;66(6):1319e1-1319e3.<br \/><br \/>Shuch B, Bratslavsky G, Linehan WM, et al. Sarcomatoid renal cell carcinoma: A comprehensive review of the biology and current treatment strategies. The Oncologist. 2012 Jan;17(1):46-54.<br \/><br \/>Tsujimura A, Miki T, Takaha M, et al. Renal leiomyoma associated with tuberous sclerosis. Urologia Internationalis. 1996 Mar;57(192):192-193.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5786\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"tab\" aria-controls=\"elementor-tab-content-5786\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Contributors<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5786\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5786\"><p>Jaime Eberle-Singh, Sherry Lee, Li Li<br \/>Thomas Jefferson University; Philadelphia, PA, USA<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5787\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"tab\" aria-controls=\"elementor-tab-content-5787\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Organ Site<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5787\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5787\"><p>Kidney<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5788\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"tab\" aria-controls=\"elementor-tab-content-5788\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Keywords<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-5788\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-5788\"><p>Kidney, leiomyoma<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>CASE OF THE WEEK Editor:&nbsp;Mahmut Akgul (akgulm@amc.edu) 2022-38\/October 3 Contributors: Jaime Eberle-Singh, Sherry Lee, Li Li A woman in her early 70s was incidentally found to have a 4.5 cm right upper pole renal mass on imaging (Figure 1A). She underwent a right partial nephrectomy. CLICK ON THE BELOW THUMBNAILS TO ENLARGE PHOTOS. Quiz Previous<br \/><a class=\"moretag\" href=\"https:\/\/iboblr.in\/gupathsociety\/cow-2022-38\/\">+ Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/page-fullwidth_template.php","meta":{"pmpro_default_level":0,"footnotes":""},"class_list":["post-7563","page","type-page","status-publish","hentry","pmpro-has-access"],"_links":{"self":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/7563","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/comments?post=7563"}],"version-history":[{"count":10,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/7563\/revisions"}],"predecessor-version":[{"id":8186,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/7563\/revisions\/8186"}],"wp:attachment":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/media?parent=7563"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}