Multifocal Synchronous Chromophobe, Papillary, and Clear Cell Renal Cell Carcinoma in a Single Kidney

We present a case of a healthy 70-year-old man who was found to have a right renal mass and benign cysts on workup of vague abdominal pain. He denied flank pain, gross hematuria, voiding symptoms, or constitutional symptoms including fever, weight loss, and night sweats. He had no significant medical comorbidities or history of malignancy. He was a non-smoker and had no occupational exposures. He had no family history of urologic malignancies. On examination, he was obese with a body mass index of 36. His skin was unremarkable without cutaneous lesions. There was neither tenderness nor palpable masses on abdominal examination. His renal function was normal with a creatinine of 1.0 mg/dL and glomerular filtration rate of 75.