Presentation
The patient is presenting with hematuria.
Patient Data
Ultrasound examination demonstrates an expansive lesion involving the right kidney with vascular involvement and tumor thrombosis in the right renal vein that extends into the IVC. Additionally, a nodular lesion adjacent to the right renal hilum is noted, suggestive of a secondary lesion. Retroperitoneal lymphadenopathy is also present.
Right renal expansive lesion involving the right kidney with endophytic presentation, vascular involvement, and tumor thrombosis in the right renal vein that extends into the IVC and left renal vein. The mass appears with heterogeneous post-contrast enhancement and less than clear renal cell carcinoma. A nodular lesion adjacent to the right renal hilum is noted, suggesting a secondary lesion. Retroperitoneal lymphadenopathy is also present.
Case Discussion
The definitive diagnosis in this case of papillary-type renal cell carcinoma was established by a renal biopsy, which revealed the specific histological characteristics associated with this tumor variant.
Papillary-type renal cell carcinoma is characterized on imaging by showing less pronounced intravenous post-contrast enhancement compared to clear cell carcinoma. In this case, given the advanced stage of the disease that limits curative options, palliative treatment has been initiated to improve the patient's quality of life.
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