A 61-year-old male presented to his GP complaining of intermittent left-sided loin pain for 2 months. An ultrasound scan of the urinary tract was organized, which showed a large central mass in the left kidney. His previous medical history included a recent diagnosis of hypertension, hypothyroidism and non-insulin-dependent diabetes mellitus. He currently takes thyroxine 100 mg od, bendrofluazide 2.5 mg od and Metformin 850 mg bd. He lives alone and drinks 5–10 units of alcohol per week. He is a lifelong smoker. Examination His temperature is 37°C, his blood pressure is 165/99 mmHg and his pulse is 84/min.
Heart sounds are normal and his chest is clear. He has a soft non-tender abdomen with no palpable masses. A left-sided varicocoele is present. Digital rectal examination is unremarkable. What investigations would suggest further? *This case is from Docplexus editorial team for…
