Presentation
Abdominal mass.
Patient Data
A very large heterogeneous mass arising from the right kidney, and displacing the remaining renal parenchyma anteromedially is noted. The mass contains mixed solid and cystic areas only only marginally enhances.
On these images, there is no convincing evidence of spread into adjacent structures. There is no convincing involvement of the renal vein or IVC. No convincing nodal or distant metastatic disease in the portions imaged.
Diagrammatic depiction of the claw sign, referring to the sharp angles on either side of the mass which the surrounding normal parenchyma forms when the mass has arisen from the parenchyma. An extrinsic mass pushing in will have blunt rounded interface with the underlying parenchyma.
Case Discussion
This case demonstrates the typical appearance of a large right-sided Wilms tumor.