Transitional cell carcinoma of the renal pelvis

Case contributed by RMH Report Writing

Presentation

Haematuria.

Patient Data

Age: 82-year-old
Gender: Male
CT

CT Abdomen and pelvis

Hyperattenuation of the left renal collecting system extending into the left ureter with associated hydronephrosis and perinephric fat stranding and thickening of the perinephric fascia. Fullness within the upper pole collecting system measuring a maximum of 3 cm. Delayed cortical enhancement and excretion within the left kidney compared to the right side with failure to opacify the left renal collecting system at 10 min postcontrast administration. Normal contrast opacification of the right renal collecting system and ureter. No filling defect present within the right renal system. Foley catheter within the urinary bladder.

Gallstones within the gallbladder. The visualised spleen, visualised liver, adrenals, pancreas and small bowel are within normal limits. Diverticulosis of the sigmoid colon. Left para-aortic lymph nodes inferior to the left renal vein measuring short axis diameter of 1 cm. Ectatic abdominal aorta measuring a maximum of 3.3 centimetres.

Bibasal atelectasis. Spinal degenerative change. No suspicious osseous abnormality.

Impression:

Delayed left renal cortical enhancement with absence of contrast extravasation at 10 min consistent with impaired left renal function. Fullness of the left upper pole collecting system measuring a maximum of 3 cm with hyperattenuating debris within the left renal collecting system. CT findings are most consistent with an underlying mass and associated haemorrhage within the collecting system. Direct visualisation and tissue sampling are recommended.

Case Discussion

Left nephro-ureterectomy revealed a TCC.

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Case information

rID: 40850
Case created: 5th Nov 2015
Last edited: 13th Nov 2016
Tag: rmh
Inclusion in quiz mode: Included

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