Renal cell carcinoma with anomalous vascular anatomy in a 15-year-old male: Case report with review of literature.

Pediatric RCC often presents late and with non-specific symptoms posing diagnostic and surgical challenges especially when associated with vascular anomalies. Case summary: A 15-year-old boy presented with a progressively enlarging right lumbar lump, intermittent painless hematuria, and early-onset hypertension. Examination showed a firm, ballotable right lumbar mass, with microscopic hematuria and elevated plasma renin. CECT revealed an 8.5 × 7 cm enhancing lower-pole right renal mass with dual arterial supply. Open radical nephrectomy was performed. Histopathology confirmed RCC-NOS, Fuhrman grade II, without lymphovascular invasion. Postoperatively, blood pressure normalized and the patient remains disease-free at 12-month follow-up.