case_images: PMC9210185_01
case_images: PMC9210185_02
case_images: PMC9210185_03
case_images: (a) Eleven-year-old male. Longitudinal greyscale ultrasound right kidney. Multiple markedly hypoechoic parenchymal masses were demonstrated (white arrows). (b) Longitudinal greyscale ultrasound left kidney. Large midpole mildly hypoechoic mass (white arrow).
case_images: SAJR-26-2406-g001.jpg
case_images: PMC9210185_03_SAJR-26-2406-g001.jpg
case_images: F0001
case_images: Initial imaging evaluation at our institution included renal ultrasound, which demonstrated multiple bilateral mild to markedly hypoechoic cortical masses (Figure 1a and b).
case_images: (a) Eleven-year-old male. T2W axial demonstrates numerous hypointense subependymal nodules (white arrows). (b) T2W axial demonstrated large subependymal giant cell astrocytoma (SEGA), with hypointense signal (white arrow). Additional subependymal nodule (black arrow). (c) Fluid inversion axial demonstrates hyperintense tubers (white arrows). (d) Axial T1-weighted precontrast image. Iso-intense subependymal nodule (white arrow). Subependymal giant cell astrocytoma (black arrow). (e) Axial fluid-attenuation inversion recovery (FLAIR) hyperintense white matter radial bands (white arrows).
case_images: SAJR-26-2406-g002.jpg
case_images: PMC9210185_03_SAJR-26-2406-g002.jpg
case_images: F0002
case_images: Brain imaging demonstrated T2-weighted hypointense subependymal nodules (Figure 2a and b) with a subependymal giant cell astrocytoma (Figure 2a to d). Fluid-attenuated inversion recovery (FLAIR) demonstrated multiple hyperintense cortical tubers (Figure 2c) and hyperintense white matter radial bands (Figure 2e).
case_images: (a) Prior to treatment. T2-weighted coronal. Enlarged left kidney with multiple bilateral hyperintense (white arrows) and more hypointense masses (black arrows). (b) T2-weighted TRUFI coronal post-sirolimus and radiofrequency ablation of the left midpole renal cell carcinoma, with size reduction of left upper pole (white arrow) and midpole renal cell carcinoma ( black arrow).
case_images: SAJR-26-2406-g003.jpg
case_images: PMC9210185_03_SAJR-26-2406-g003.jpg
case_images: F0003
case_images: Abdominal MRI demonstrated numerous bilateral renal cortical T2-weighted hypo to hyperintense (Figures 3a and b), T1-weighted hypointense mass lesions (Figure 4a). Technical success was confirmed at post-ablation MRI (Figure 3b).
case_images: (a) T1-weighted axial abdomen demonstrates bilateral iso-intense renal mass lesions (white arrows). (b) T1-weighted axial abdomen post-contrast demonstrated enhancement of the bilateral renal mass lesions (black arrows). (c) T1-weighted coronal abdomen post-contrast demonstrates enhancement of bilateral renal mass lesions (white arrows).
case_images: SAJR-26-2406-g004.jpg
case_images: PMC9210185_03_SAJR-26-2406-g004.jpg
case_images: F0004
case_images: Abdominal MRI demonstrated numerous bilateral renal cortical T2-weighted hypo to hyperintense (Figures 3a and b), T1-weighted hypointense mass lesions (Figure 4a). Post-contrast enhancement of bilateral renal mass lesions was seen. (Figure 4b and c).