Figure 1: (a) Pre-op CT scan showing large heterogeneous mass in renal area with large hypo-intense non-fatty dedifferentiated area (white arrow) and smaller hyper-intense fatty area (red arrow) along with IVC thrombus with largely nonfatty area (cross). (c) Mass comprised of large necrotic tan brown area (white arrow) with smaller fleshy white area (black arrow). (b) Kidney (marked by cross) was encased by the tumor and could be easily shelled out from mass except at renal sinus (arrow head). (d) Intra-operative removal of tumor thrombus (cross) at renal vein outlet (arrow)