Urothelial carcinoma

Case contributed by Dr Michael P Hartung

Presentation

Flank pain, hematuria.

Patient Data

Age: 65 years
Gender: Female
CT

CT flank pain

Masslike enlargement of the left mid through upper kidney with involvement of the adrenal gland. Dense material in the renal pelvis and proximal ureter. Adenopathy along the medial aspect.  

CT

Follow-up contrast study

Infiltrative mass replacing and expanding the left upper half of the kidney. Extends into left adrenal gland. Small surrounding lymph nodes. Left ureteral thickening and enhancement.

Case Discussion

Notice how easy it would be to misinterpret the flank pain study as pyelonephritis, particularly on the axial images. The masslike involvement becomes much more apparent on the coronal reformats, and the extent of disease is better characterized on the follow-up contrast enhanced exam. This diagnosis of urothelial carcinoma was confirmed by ultrasound-guided biopsy of the kidney. 

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Case information

rID: 78381
Published: 3rd Jun 2020
Last edited: 4th Jun 2020
System: Urogenital
Inclusion in quiz mode: Included

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