PMC4203475_01
A CT scan of the abdomen and pelvis showing a left renal mass 13 cm in diameter with features suggestive of primary RCC.
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A computed tomography (CT) scan of the abdomen and pelvis revealed a left renal mass (measuring 13 cm in diameter) with imaging characteristics suggestive of primary RCC (Figure 1).
MRI of the spine sagittal section showing anterior and posterior parallel thick lines of avid enhancement corresponding to the leptomeninges, which is highly abnormal and indicates leptomeningeal carcinomatosis.
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MRI of the spine demonstrated nodular enhancement of the spinal cord with diffuse leptomeningeal involvement along with osseous metastasis (Figure 2).
A histopathological exam confirming papillary RCC.
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Since the patient was not a surgical candidate because of diffuse leptomeningeal involvement, he underwent further workup with biopsy of the renal mas which showed nonclear cells with immunophenotype staining positive for racemase, ck7, and negative for CD10, consistent with papillary sub-type of RCC (Figures 3 and 4).
A histopathological exam confirming papillary RCC.
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Since the patient was not a surgical candidate because of diffuse leptomeningeal involvement, he underwent further workup with biopsy of the renal mas which showed nonclear cells with immunophenotype staining positive for racemase, ck7, and negative for CD10, consistent with papillary sub-type of RCC (Figures 3 and 4).