Renal cell carcinoma

Case contributed by Dr Mahomed A. Osman

Patient Data

Age: 65
Gender: Male
Modality: CT

There is a large heterogenous soft tissue mass arising in the posterior left kidney, with surrounding fat stranding. There mass appears to involve the left renal vein which is indistinct from surrounding structures at its distal end. There is relative hypoenhancement and of the left kidney compared to the right. The mass does not invade through Gerota's fascia. No lymphadenopathy. Appearances are consistent with a renal cell carcinoma, invading the left renal vein.

There is a small cortical cyst, anterior aspect of the lower pole of the left kidney. A larger cyst is also present at the posterior aspect of the superior pole, left kidney. The right kidney shows a tiny cortical cyst at the inferior pole. The left renal pelvis and ureter cannot be identified on renal excretory phase.

Degenerative changes of the imaged lumbar and thoracic spine are noted. The remaining imaged abdominal viscera are normal in appearance, with no evidence of metastasis, however distal metastasis is not excluded given the limited imaging.

Case Discussion

This patient went on to have a radical nephrectomy. The pathology report reads as follows:

Sections show  a multinodular  tumour  consistent with clear cell renal cell carcinoma. There is direct extension of tumour into the renal vein. Surrounding lymph nodes are normal. The left adrenal gland is normal.

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Case Information

rID: 22630
Case created: 12th Apr 2013
Last edited: 4th Dec 2015
System: Urogenital
Inclusion in quiz mode: Included

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