Presentation
Right flank pain and hematuria.
Patient Data
work up for Rt flank pain & hematuria
Non contrasted CT images show two 65 mm and 40 mm soft tissue density masses at right kidney. There is no fat component within the masses.
A few small cortical cysts are present bilaterally. A 14 mm small parenchymal hyper dense lesion is also observed at mid portion of right kidney. No renal or ureteral stones are present at both sides.
The prostate gland is enlarged.
Degenerative changes as osteophytosis are seen at the lumbar spine.
A 65 mm mass is again identified in the upper pole of the right kidney. It is iso signal on T1W and is iso to high signal on T2WI. After contrast injection, the mass shows slight enhancement.
A second 40 mm heterogeneous mass is seen at posterior aspect of right renal mid pole. It is iso to low signal on T1W and iso to high signal on T2WI. After contrast injection, it shows heterogeneous enhancement. Fat component is not demonstrated within the two masses.
There is no perirenal fat infiltration and vascular invasion.
There is no hydronephrosis.
A few cortical cysts are observed in both kidneys.
A 14 mm hemorrhagic cyst is seen in the right kidney.
Case Discussion
Right renal masses; pathology proven clear cell renal cell carcinoma. No local invasion, vascular extension, regional lymphadenopathy or detectable metastasis.
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