Presentation
Hematuria with a palpable right abdominal mass.
Patient Data
Large heterogeneously enhancing soft tissue mass arising mainly from the mid-zone and lower pole of the right kidney with areas of cystic necrosis as well as peripheral arciform calcification. There is an extension to the renal sinus with deformed and dilated renal cavities. An intraluminal thrombus of the IVC is noted. The right renal vein is compressed and not well-demonstrated. A mass effect is noted on the duodenum and pancreatic head which are displaced to the midline as well as on the liver showing upwards displacement with an irregular interface with the tumor.
No lymph-node involvement or peritoneal spread. No lung metastasis (lung window not shown).
Normal appearance of the left kidney.
Case Discussion
CT features of a large heterogeneously enhancing right renal mass most consistent with Wilms tumor with tumoral thrombus within the IVC.