Abdominal and scrotal ultrasounds were requested and, in order of the findings watched they were complemented with an abdominal contrast enhanced CT scan (CECT). The CETC demonstrated a large right renal tumor sized 12 cm located in the upper pole of the right kidney, in contact with hepatic parenchyma (Figure 1). Renal vein and artery were not affected. Important peritumoral collateral circulation was noticed. Consequently to the large tumor size and extrinsic compression, there was dilatation of right spermatic vein. Both Collateral circulation and right spermatic dilated vein converged in the inguinal duct explaining the presence of right varicocele. The image was 3D reconstructed.

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