case_images: PMC5345533_01
case_images: A. Axial postcontrast CT image demonstrating the 2 cm cortical based mass in the inferior left kidney (red arrow). B. Coronal postcontrast fat-suppressed T1-weighted MR image demonstrating the 4.5 cm infiltrative mass in the inferior left kidney. C. Demonstrates a filling defect in the left renal vein (yellow arrow), representing tumor thrombus, approaching but not quite extending into the IVC.
case_images: jkcvhl-2-130-g001.jpg
case_images: PMC5345533_01_jkcvhl-2-130-g001.jpg
case_images: F1
case_images: His initial abdominal CT, performed for flank pain, showed an approximately 2 cm cortically based mass in the left kidney (Figure 1A). This again showed the left renal mass, which had grown to 4.5 cm and had an infiltrative appearance (Figure 1B). CT urography, performed approximately 1 month after the MRI, showed further growth of the infiltrative left renal mass to 5.2 cm along with thrombus of the left renal vein (Figure 1C).
case_images: A. Axial fused PET/CT image demonstrating an 8.5 x 6.5 cm soft tissue mass in the left renal fossa (red arrow) with mild FDG uptake. There is physiologic FDG uptake in the liver, bowel, and right kidney. B. Transverse Tc-99m sulfur colloid scintigram showing uptake by the liver and spleen (red arrow), with the latter located in the left renal fossa.
case_images: jkcvhl-2-130-g002.jpg
case_images: PMC5345533_01_jkcvhl-2-130-g002.jpg
case_images: F2
case_images: Follow-up fluorine-18-fluorodeoxyglucose (FDG) PET/CT approximately 3 months following surgery demonstrated an 8.5 x 6.5 cm soft tissue mass in the left renal fossa with mild F-18-FDG uptake (SUV max of 2, with a background of 1.5) (Figure 2A). A technetium-99m sulfur colloid scan was then performed, confirming the location of the spleen in the left renal fossa (Figure 2B).