Wilms tumor - stage IV

Large heterogeneous right renal mass deforming the renal contours and renal cavities with enlarged lymph nodes and thrombosis of the IVC.

There is a large lobulated right renal mass measuring 14 x 10 x 8 cm deforming the renal cavities which are dilated. It displays a low signal on T1 with areas of high signal (bleeding within dilated calyces), inhomogeneous high signal on T2 with heterogeneous enhancement following IV contrast. Thrombosis of the right renal and IVC with an intraluminal thrombus extending up to the left common iliac vein. Enlarged lymph nodes are noted at the periportal and celiac regions. Upward displacement of the liver and right adrenal gland with no apparent involvement or metastasis. The left adrenal gland and kidney are normal. Numerous small metastatic nodules are noted in the lung bases.