PMC3738331_01
(a) Axial and (b, c) coronal excretory phase contrast CT showing a multilocular cystic mass with a polypoid part continuously extending into the pelvis and ureter (white arrow); (d) Retrograde ureterography showing a polypoid tumor in the pelvis and proximal ureter and moderate hydronephrosis (white arrow heads)
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CT (Fig. 1a-c) showed a well-circumscribed multiseptate cystic mass of 44 x 40 x 45 mm in the interpolar region of the left kidney with a polypoid solid component protruding into the renal pelvis and proximal ureter. Calcification was identified within the solid component. Retrograde ureterography (Fig. 1d) showed mild hydronephrosis due to the polypoid part of the tumor in the ureter.
(a, b, c, d) Continuous slices of coronal T2-weighted MRI showing a well-circumscribed multiseptate cystic mass with a polypoid compartment extending into the renal pelvis and proximal ureter
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Dynamic MRI study (Figs. 2 and 3) demonstrated delayed contrast enhancement of the solid polypoid component and multiple septa.
(a) Axial pre-enhanced, (b) axial arterial phase, (c) axial medullary phase fat-saturated T1-weighted MRI. Dynamic MRI study demonstrates delayed enhancement in the polypoid lesion and septa; (d, e, f) Continuous coronal excretory phase fat-saturated T1-weighted MRI showing marked enhancement in the polypoid lesion
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Dynamic MRI study (Figs. 2 and 3) demonstrated delayed contrast enhancement of the solid polypoid component and multiple septa.
(a) Gross specimen showing a cystic lesion with septa and a sharply marginated solid polypoid lesion; (b) Photomicrograph of the polypoid lesion showing proliferation of stroma, superficially covered with urothelium (black arrow) (hematoxylin and eosin stain; x200); (c) Low-power-view and (d) high power-view of the cystic lesion demonstrating an admixture of spindle cells resembling ovarian stroma and epithelial elements consisting of varying sized glands (c, x100; d, x400; hematoxylin and eosin stain)
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Gross examination showed a well-marginated multilocular cystic mass with a polypoid solid component protruding into the renal pelvis and ureter (Fig. 4a).