Non- contrast phase CT shows the large mass in the RUQ with layered hyperdensity central in keeping with internal haemorrhage.
Biphasic contrast injection or "split bolus" injection was used to assess both portal venous and arterial phase in a single acquisition to reduce radiation dose.
The post contrast images show no active contrast extravasation to suggest active bleeding. The soft tissue vascular mass arises from the right kidney as evidenced by the "claw sign". There is no intra-lesional fat or calcification.
The mass also appears in close contact with the liver were focal areas appeared to be crossing the liver capsule in the right lobe which is worrying for local invasion of the liver.
Of note IVC is significantly compressed by the mass which may have been contributing to cardiovascular instability due to lack of preload.
No metastatic disease demonstrated.