Presentation
Hematuria.
Patient Data
There is a large hetero signal enhancing masses with the internal signal void foci involving the upper and mid poles of the right kidney.
Renal vein is infiltrated by the multiple soft tissue metastatic lesions.
Extension of a tumor via the right renal vein into the IVC also is noted.
Abnormal soft tissue enhancing masses invaded the adrenal gland in the right side.
There are multiple metastatic lymphadenopathies at the para-caval, aorto-caval, para aortic and the right retro crural regions.
another soft tissue enhancing nodule is noted at the lower zone of the right lung could be due to the metastatic lesion.
Case Discussion
Regarding to the imaging findinges and TNM staging :
Stage IV(T4 N1 M1) renal cell carcinoma with tumor thrombosis and involving the adjacent and distant sites is the probable diagnosis.
Unable to process the form. Check for errors and try again.