PMC3169898_01
Gray-scale longitudinal image of the right kidney shows a hypoechoic mass (arrows) measuring approximately 5 cm. There is an anechoic cortical cyst beside this lesion.
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F1
A hypoechoic, heterogeneous, solid renal mass seen on US was attributed to renal malignancy [Figure 1].
(a) T2-weighted MRI reveals a right renal parenchymal mass (arrow) located posteriorly with peripheral hypointense solid and central hyperintense cystic component and extension to the paraspinal/pernephric region. (b) After gadolinium administration, axial image shows that peripheral solid component and septa formations of lesion enhance earlier but less than the surrounding renal parenchyma, suggesting malignancy. (c) Coronal image shows septal enhancement and extension of the right renal mass into the psoas muscle. There is no extension into the renal vein.
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F2
Other imaging features were invasion of the psoas muscle posteriorly and enhancement of the mass in the delayed phase after intravenous gadolinium injection [Figure 2].
Six months after the first presentation of the patient, the CT examination conducted after administration of iodinated contrast agent yielded complete resolution of the right renal mass on (a) axial and (b) coronal images.
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F3
The patient had palliative medical treatment and the CT done 3 months later revealed significant regression in the size of the mass lesion with the relief of symptoms [Figure 3].