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A 64-year old male with a 6-cm grade 4 clear-cell renal carcinoma with sarcomatoid elements and macroscopic sinus fat invasion, microscopic perinephric invasion and no venous involvement. The tumour abuts sinus fat (long arrow) and the perirenal fascia (short arrow). Contact with the perirenal fascia was a risk factor for perinephric invasion (see text).
