PMC10081889_01
Radiographic findings. (a) Contrast-enhanced CT abdomen on initial presentation demonstrating an enlarged right kidney with hydronephrosis and perinephric stranding which is consistent with the "bear claw sign" that suggests XGP. (b) Contrast-enhanced CT abdomen prior to nephrectomy demonstrating aggressive progression of right kidney disease with invasion of surrounding structures. (c) Contrast-enhanced CT abdomen demonstrating multiple biopsy-confirmed metastatic liver lesions from urothelial carcinoma.
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A CT chest, abdomen, and pelvis with contrast was performed which demonstrated perinephric stranding, marked hydronephrosis, and marked thinning of the right renal parenchyma (Figure 1(a)). A CT abdomen/pelvis showed significant progression of the right XGP as well as a new infiltrative process of the right renal pelvis with possible right renal vein thrombosis (Figure 1(b)). A CT abdomen/pelvis two months later in September 2021, however, was significant for multiple new poorly defined hepatic hypodensities with concern for metastatic disease versus abscesses related to disseminated infection (Figure 1(c)).