Wilms tumor

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Right flank pain with a palpable mass.

Patient Data

Age: 5 years
Gender: Female
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Axial renal
excretory phase
This study is a stack
Sagittal C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Info

Heterogeneously enhancing exophytic soft tissue mass of the right kidney centered on the lower pole, invading the renal sinus with capsular effraction and infiltration of the perirenal fat with thickening of the anterior renal fascia. Thrombosis of the right renal vein and the adjacent segment of the IVC.

The tumor appears in contact with the hepatic flexure and ascending colon with effacement of the fatty interface. Minimal effusion is noted in the right paracolic gutter.

No evidence of nodal or distant abdominal metastatic disease.

Case Discussion

CT features of a large soft tissue mass of the right kidney invading the renal vein and IVC most consistent with Wilms tumor.

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