Patient History: 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.
Physical 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. Laboratory Findings: What are the diagnosis and necessary next step…
