Renal Tumour

This 75 year-old male patient presented with symptoms of urinary tract obstruction and a renal ultrasound was performed. There is a mass in the upper pole of the right kidney with heterogeneous echogenicity. Doppler examination showed pulsatile flow within the mass. The mass is expansile and exophytic. The features are suspicious for renal cell carcinoma.
Three phase CT was performed, which confirmed the presence of a mass. Strong arterial phase enhancement again suggests a probable renal cell carcinoma. No evidence of metastatic disease or renal vein involvement was seen.
More than half of renal cell carcinomas are incidental findings on CT, US or MR. Typically they are hypervascular renal cortical masses. Small lesions are usually best seen in the nephrographic phase of CT, rather than arterial or corticomedullary. Metastases to lung and bone are frequent. RCC is associated with von Hippel-Lindau disease, tuberous sclerosis, acquired cystic renal disease, and familial renal cell carcinoma.
Reference: Federle et al. Pocket Radiologist: Abdominal Top 100 Diagnoses Amirsys 2003.
Credit: Dr Laughlin Dawes
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