Case of the Month: May 2025

Clinical history

A 73-year-old male presents to the clinic for evaluation after an incidental finding of a small right kidney mass on an abdominal CT scan.

Additional history reveals:

• Medical History: Uncontrolled hypertension (BP 155/98, not on medication), obesity (BMI 32 kg/m²), benign prostatic hyperplasia managed with tamsulosin 0.4 mg daily, and end-stage renal disease (ESRD) on conservative management.
• Social History: Smoker with a 30 pack-year history.
• Family History: Unremarkable.
• Occupational History: Worked in ceiling installation for 20 years with confirmed asbestos exposure.
• Clinical Examination: No significant findings on physical exam.

Questions:

• What is the differential diagnosis?

• What are the characteristic clinical presentation?

• What are the next steps in managing this patient?

How to participate

Take a look at the images.

Anyone is welcome to try to solve the puzzle by commenting on the related post on our Instagram.

If you are a medical student at the University of Toronto, you can also:

• Fill out the online form
• Join the related lecture

If you do, you are in for a chance to win a $100 gift card! (UofT Med students only).

If you are a current medical student at U of T, you can register to join the January case of the month lecture online or in person and have a chance to win a $100 gift card!

You can also join the Special Interest Group in Laboratory Medicine to learn more about Laboratory Medicine.