Abstract
With the continuous advancement of diagnostic technologies, an increasing number of renal and renal vascular lesions are being detected. However, cases involving renal tumors concurrent with renal vascular lesions remain exceedingly rare, and there is currently no established consensus regarding their optimal diagnosis and treatment strategies. Renal tumors often necessitate radical nephrectomy, which typically precludes the preservation of the affected kidney. In this report, we present the case of a young female patient diagnosed with a right-sided renal tumor in conjunction with bilateral renal artery aneurysms, who successfully underwent a kidney-preserving surgical procedure. Although preoperative imaging and MDT review suggested a malignant renal neoplasm, final histopathology demonstrated aneurysmal vascular wall with fibrointimal hyperplasia, hyalinization, calcification/ossification, and luminal thrombosis, without evidence of a true renal tumor. This radiologic–pathologic discordance explains the mass-like appearance on imaging.