Renal cell carcinoma - Color Ultrasound


Title: Color Ultrasound - Renal cell carcinoma
Diagnosis: Renal cell carcinoma
Author: Dr.ROSSET Antoine
Comment: Dr. KHAN Haleem
Hospital: HUG
Department: Radiologie
State: Terminée
Date: 21.03.2003
: 4300
Chapter: Urology

Clinical Presentation: Incidentally discovered renal mass in apatient who was
investigated for a liver lesion in a setting ofhepatic cirrhosis(note Endorem MR study!)
Comment: With the advent of high resolution sonography andspiral CT small RCC
are more readily discovered at an earlierstage. The classic triad of symptoms(flank pain,
hematuria and apalpable renal mass )is seen in only 4-9% of cases. On sonographythe
tumors present as a solid mass that are often isoechoic (86%),or can be hypo or
hyperechoic. Tumors that are smaller than 3 cmtend to be hyperechoic. 5% of tumors can
be cystic. Most tumorswill will show high vascularity which is is highly sensitive
formalignancy. Tumor extension to the renal vein or the inferior venacava can also be
seen by Color Doppler US. CT is however superiorto Color Doppler US in staging renal
tumors. MR can be analternative in cases of equivocal CT findings or in patients inrenal
insufficiency or presenting an allergy to iodinated contrastmedia.
Description: Sonography reveals a well defined solid slightlyhyperechoic mass of
the upper pole of the kidneys with a centrallyhypoechoic region. The lesion is
hypovascular relative to adjacentnormal renal tissue on the doppler scan. MR findings are
consistentwith a solid renal mass containing a central zone ofnecrosis(hyperintense on the
T2 weighted scan). Surgery confirmedthe diagnosis of renal cell carcinoma(RCC).

Order: 1060
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

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