case_images: PMC4996584_01
case_images: Axial view of CT urogram demonstrates a 1.5 cm filling defect in the right renal pelvis.
case_images: fig-1.jpg
case_images: PMC4996584_01_fig-1.jpg
case_images: f1
case_images: A CT urogram delineated a 1.5 cm right renal pelvic lesion with no evidence of local advancement or LAD in the abdomen or pelvis (Fig. 1).
case_images: (a) CT scan demonstrating 3.3 cm right external iliac node (vertical arrow), right external iliac vein (asterisk), and right external iliac artery (horizontal arrow). (b) CT scan showing 3.2 cm right obturator lymph node enlargement (vertical arrow).
case_images: fig-2.jpg
case_images: PMC4996584_01_fig-2.jpg
case_images: f2
case_images: A CT scan of the chest, abdomen, and pelvis demonstrated new onset of right-sided pelvic LAD with a 3.3 cm right external iliac node (Fig. 2a), 1.6 cm right common iliac node, and 3.2 cm right obturator node (Fig. 2b).
case_images: PMC4996584_02
case_images: (a) Coronal views on CT urogram show 2.6 cm right distal ureteral defect (red arrow). (b) Simultaneous 1.5 cm left renal pelvic filling defect (red arrow).
case_images: fig-3.jpg
case_images: PMC4996584_02_fig-3.jpg
case_images: f3
case_images: A CT urogram demonstrated a 1.5 cm left renal pelvic filling defect and a 2.5 cm right distal ureteral filling defect, but no evidence of locally advanced or metastatic disease was present (Fig. 3a, b).
case_images: MRI of the abdomen demonstrates an enlarged 2.0 cm left para-aortic lymph node with enhancement after gadolinium (red arrow).
case_images: fig-4.jpg
case_images: PMC4996584_02_fig-4.jpg
case_images: f4
case_images: Periodic cross-sectional imaging had been performed regularly but a new 2.0 cm left para-aortic lymph node concerning for metastatic disease was discovered on an MRI, 20 months after initial presentation (Fig. 4).