Presentation
Ultrasound performed for acute renal failure. Mass identified. Proceeded to CT.
Patient Data
10.7 x 10.6 cm heterogeneously enhancing right renal lower pole mass with extensive central necrosis. The mass invades the infradiaphragmatic IVC which is markedly distended, measuring 2 cm with tumor thrombus within. Additional nodular thickening in the wall of the infrarenal component of the IVC. Bland thrombus in the proximal left renal vein. The mass abuts the right psoas muscle, segment V of liver, and 2nd part of duodenum without invasion.
Small cysts seen in liver, largest 7 mm in segment III.
No significant infradiaphragmatic lymphadenopathy.
No focal bone lesions.
Case Discussion
Ultrasound-guided biopsy of this mass confirmed a renal cell carcinoma.
This is an example of a huge renal cell carcinoma with pronounced IVC tumor invasion. The size of the IVC is greatly increased in diameter from the tumor thrombus within.
The radiolgoical stage is T3c.