A left kidney mass was found during a physical examination 20 days ago. Male, 70 years old. The patient underwent a urinary system ultrasound during a physical examination 20 days ago, which showed a moderate echo in the middle of the left kidney, measuring approximately 4.5 cm × 2.6 cm × 3.2 cm, with a regular shape, clear boundary, slightly protruding outward, and uneven internal echo. CDFI: peripheral and internal dot and strip blood flow signals. A left kidney mass was considered, and further examination was suggested. Subsequently, an enhanced abdominal CT was performed, which showed a slightly high-density round mass in the middle of the left kidney, with a strip of low-density shadow inside, a plain CT value of about 37 HU, unclear boundary, and a size of about 3.1 cm × 2.8 cm. The arterial phase was significantly enhanced during the enhanced scan, and the venous phase and delayed phase exited (Fig. 1). Malignant lesions were considered, with a high possibility of clear cell carcinoma. PET-CT examination suggested a slightly high-density nodule on the posterior lip of the left kidney, with a diameter of 2.9 cm, slightly increased radioactive uptake, SUVmx5.3, considering a slightly high-density nodule in the left kidney, and increased metabolism, suggesting further examination to rule out malignant lesions. The patient denied symptoms such as fever, frequent urination, urgency, dysuria, back pain, afternoon fever, night sweats, gross hematuria, etc. He was admitted to our hospital for further surgical treatment.