Clinical Presentation
A 62-year-old patient complains of right flank pain.
Fig. 64.1 (A) Noncontrast CT image shows an inferior vena cava filter in place. There is an exophytic low-attenuating lesion arising from the right kidney, with thickening seen along the right lateral wall. (B) Following the administration of contrast, there is an enhancing nodule (arrow) seen within the lesion. In addition, there are ill-defined septations and thickening of the left lateral wall.
Radiologic Findings
Noncontrast computed tomography (CT) image shows an inferior vena cava filter in place. There is an exophytic low-attenuating lesion arising from the right kidney, with thickening seen along the right lateral wall (Fig. 64.1A). Following the administration of contrast, there is an enhancing nodule seen within the lesion (Fig. 64.1B). In addition, there are ill-defined septations and thickening of the left lateral wall.
Diagnosis
Cystic renal cell carcinoma (RCC)
Differential Diagnosis
- Renal abscess
- Complex inflammatory or infected renal cyst
- Cystic metastases
- Solid RCC with cystic degeneration
Discussion
Background
RCCs account for 85% of all renal malignancies. They are usually solid, but up to 20% can be cystic.
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