case_images: PMC6180855_01
case_images: Axial portal-phase CT scan showing (a) a large amount of solid tissue in the left perirenal space and a smaller amount on the contralateral side (red arrows) and (b) a partial stenosis of the common bile duct owing to hypervascular eccentric tissue (white arrow). (c) Coronal portal-phase CT image showing left perirenal (red arrow) and peribiliary localization (white arrow).
case_images: bjrcr.20150099.g001.jpg
case_images: PMC6180855_01_bjrcr.20150099.g001.jpg
case_images: fig1
case_images: Similar findings were detected also in the right perirenal space (Figure 1a,c). CT images also revealed a partial stenosis of the common bile duct, with intrahepatic bile duct ectasia owing to hypervascular eccentric tissue (Figure 1b,c).
case_images: (a) Axial portal-phase CT scan performed after 3 months of medical therapy shows a marked reduction in size of the perirenal tissue on both sides (red arrows). (b) Coronal portal-phase CT image showing a similar reduction in size of the peribiliary tissue (white arrow); a residual ectasia of intrahepatic bile ducts was observed.
case_images: bjrcr.20150099.g002.jpg
case_images: PMC6180855_01_bjrcr.20150099.g002.jpg
case_images: fig2
case_images: Unexpectedly, on venous phase images, the perirenal tissue showed a remarkable reduction on the left side and had almost disappeared on the right side (Figure 2a). The peribiliary tissue had equally decreased in size and thickness (Figure 2b).
case_images: (a) Axial portal-phase CT scan performed 1 year later showing new solid tissue surrounding the right renal pelvis and calices (red arrow). (b) Coronal delayed-phase CT image confirming the presence of solid tissue infiltrating the renal pelvis (red arrow).
case_images: bjrcr.20150099.g003.jpg
case_images: PMC6180855_01_bjrcr.20150099.g003.jpg
case_images: fig3
case_images: The treatment was then discontinued in accordance with the patient's decision. 1 year later, both the left perirenal and peribiliary tissues demonstrated no progression and remained clinically stable on off-treatment; however, new tissue was visible surrounding the right renal pelvis and the calices (Figure 3a,b).