Renal Cell Carcinoma

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Slideshow

  • This primary care provider could not feel these patients during a normal pelvic exam ovaries and ordered an abdominal ultrasound, which revealed a tumor on the right kidney. The tumor was initially diagnosed as an angiomyolipoma.

    CA0911ClinicalChallenge_Fig1

    This primary care provider could not feel these patients during a normal pelvic exam ovaries and ordered an abdominal ultrasound, which revealed a tumor on the right kidney. The tumor was initially diagnosed as an angiomyolipoma.

  • Four months later, a second ultrasound confirmed an 8-mm echogenic nodule. A triphasic renal CT with IV contrast ordered nine months later to confirm the angiomyolipoma revealed a fat-poor, hypovascular tumor that enhanced from 34 to 70 Hounsfield units. In comparison with previous ultrasound studies, it appeared to have more than doubled in size to 1.6 cm. The decided diagnosis was renal cell carcinoma. 



    CA0911ClinicalChallenge_Fig2

    Four months later, a second ultrasound confirmed an 8-mm echogenic nodule. A triphasic renal CT with IV contrast ordered nine months later to confirm the angiomyolipoma revealed a fat-poor, hypovascular tumor that enhanced from 34 to 70 Hounsfield units. In comparison with previous ultrasound studies, it appeared to have more than doubled in size to 1.6 cm. The decided diagnosis was renal cell carcinoma. 



  • After partial nephrectomy, kidney function was normal.

    CA0911ClinicalChallenge_Fig3

    After partial nephrectomy, kidney function was normal.

This 64-year-old female patient, was referred to our clinic with an enlarging right renal tumor. The tumor was incidentally detected on ultrasound, which her primary-care provider (PCP) ordered in response to her nonpalpable ovaries. 



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