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We report a relatively rare case of renal replacement lipomatosis presenting as a renal mass. Computed tomography revealed a predominantly low-density and roundish mass, with an irregular renal parenchyma, high-density calcification, and abundant low-density fat. The differential diagnosis before surgery was squamous cell carcinoma, teratoma, or angiomyolipoma of the kidney. The case was initially misdiagnosed, because we had no experience with this disease. After mass exploration, histological examination confirmed the diagnosis of renal replacement lipomatosis. The patient was free from signs of recurrence 10 months after the operation.
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