📄 SCRS
Renal Cell Carcinoma (RCC)
Renal Cell Carcinoma (RCC) ultrasound case study
USG
Renal Cell Carcinoma (RCC) ultrasound case study
| SN | Case Name | Report Line |
|---|---|---|
| 1 | Renal Cell Carcinoma (RCC) | View Report Line |
| 2 | Cystic RCC | View Report Line |
| 3 | RCC with renal vein invasion | View Report Line |
| 4 | RCC with inferior vena cava (IVC) extension | View Report Line |
| Mimic RCC on Ultrasound | ||
| 5 | Angiomyolipoma | View Report Line |
| 6 | Oncocytoma | View Report Line |
| 7 | Complex Renal Cyst | View Report Line |
| 8 | Renal Abscess | View Report Line |
| 9 | Xanthogranulomatous Pyelonephritis | View Report Line |
| 10 | Multifocal Renal Cell Carcinoma | View Report Line |
| 11 | Bilateral Renal Cell Carcinoma | View Report Line |
| 12 | Recurrent Renal Cell Carcinoma | View Report Line |
| 13 | Metastatic Renal Cell Carcinoma | View Report Line |
| 14 | Clear Cell Renal Cell Carcinoma | View Report Line |
| 15 | Papillary Renal Cell Carcinoma | View Report Line |
| 16 | Chromophobe Renal Cell Carcinoma | View Report Line |
| 17 | Unclassified Renal Cell Carcinoma | View Report Line |
CASE–1
Right Renal Cell Carcinoma (RCC)
Right Renal Cell Carcinoma (RCC)
Clinical History
A 62-year-old male presented with intermittent right flank pain and painless hematuria for two months. The patient also reported unintentional weight loss and generalized weakness. Ultrasound examination of the abdomen with Color Doppler was performed to evaluate the right kidney.
Ultrasound Findings
Ultrasound examination demonstrates a heterogeneous solid mass arising from the upper/mid pole of the right kidney, measuring approximately 6.8 × 5.9 × 5.6 cm. The lesion is predominantly heterogeneous with mixed echogenicity and contains small central hypoechoic areas consistent with necrosis. The mass produces focal outward bulging of the renal contour with partial distortion of the corticomedullary architecture. Color Doppler demonstrates internal vascularity within the lesion. No definite calcification is identified. There is no hydronephrosis. The right renal vein and inferior vena cava appear patent without sonographic evidence of tumor thrombus. The left kidney appears normal.
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| Renal ultrasound. Longitudinal sonographic image demonstrates a heterogeneous solid mass arising from the right kidney with internal Color Doppler vascularity, highly suspicious for renal cell carcinoma (RCC). |
Report Line
A heterogeneous vascular solid mass measuring approximately 6.8 × 5.9 × 5.6 cm is identified arising from the upper/mid pole of the right kidney. Internal Color Doppler vascularity and small central necrotic areas are present. No sonographic evidence of right renal vein or inferior vena cava invasion is identified on the current examination. Findings are highly suspicious for renal cell carcinoma (RCC).
Impression
Heterogeneous vascular solid mass arising from the right kidney, highly suspicious for renal cell carcinoma (RCC).
No sonographic evidence of right renal vein or inferior vena cava tumor thrombus on the current examination.
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No sonographic evidence of right renal vein or inferior vena cava tumor thrombus on the current examination.
Recommendation
Contrast-enhanced CT or MRI of the abdomen and pelvis using a dedicated renal mass protocol is recommended for lesion characterization, local staging, and assessment for renal vein or inferior vena cava invasion. Urology consultation is advised for further evaluation and management. CT chest should be considered for metastatic staging. Histopathological confirmation following surgical excision or biopsy should be obtained when clinically indicated.
Key Learning Points
- Renal cell carcinoma (RCC) is the most common primary malignant renal tumor in adults.
- On ultrasound, RCC usually appears as a heterogeneous solid renal mass with variable echogenicity.
- Color Doppler typically demonstrates internal vascularity, helping distinguish RCC from simple renal cysts.
- Larger tumors commonly demonstrate areas of necrosis, hemorrhage, or cystic degeneration.
- Ultrasound should assess for renal vein and inferior vena cava (IVC) tumor thrombus, which significantly affects staging and surgical planning.
- Contrast-enhanced CT or MRI is the imaging modality of choice for characterization and staging of RCC.
- Differential diagnoses include oncocytoma, angiomyolipoma, complex renal cyst (Bosniak III/IV), renal abscess, and xanthogranulomatous pyelonephritis.
CASE–2
Cystic Renal Cell Carcinoma (RCC)
Cystic Renal Cell Carcinoma (RCC)
Clinical History
A 59-year-old male presented with intermittent painless hematuria and right flank discomfort for three months. Ultrasound examination of the abdomen with Color Doppler was performed for evaluation of a complex right renal cyst detected on previous imaging.
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| Renal ultrasound. Longitudinal sonographic image demonstrates a complex cystic mass with thick septations and vascular mural nodules arising from the right kidney, suspicious for cystic renal cell carcinoma. |
Report Line
A complex cystic mass measuring approximately 5.8 × 4.9 × 4.6 cm is identified arising from the right kidney. Thick irregular septations and enhancing mural nodules demonstrate internal Color Doppler vascularity. Findings are highly suspicious for cystic renal cell carcinoma (Bosniak IV lesion). No sonographic evidence of renal vein or inferior vena cava invasion is identified.
Impression
Complex Bosniak IV cystic lesion of the right kidney, highly suspicious for cystic renal cell carcinoma.
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