With high frequency, renal masses are incidentally identified by imaging methods, many of these are renal cell carcinomas, the objective of imaging studies is to differentiate a benign mass from a renal cell carcinoma, up to 20% of the cases. Indeterminate solid renal masses finally turn out to be benign with a higher incidence of benignity in small renal masses (less than 4cm), however in some cases it is not possible to differentiate them; there are radiological signs that incline the diagnosis towards malignancy or benignity, and significantly affect the diagnosis, characterization, staging, orientation of treatment (partial and radical nephrectomy, biopsy and tumor ablation) as well as subsequent evaluation. Presentation of a case of a 74-year-old male patient, who came with abdominal pain in the left flank as the only symptomatology, where after clinical evaluation, complementary ul...