PMC7323720_01
Ultrasound detected multiple hypoechogenic, round shaped, inhomogeneous renal mass (white arrow)
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F1
Abdominal ultrasound reveals multiple, round, hypoechoic nodules with a maximum diameter located to the renal parenchyma with bilateral involvement (Figure 1), three hypoechoic nodules located inside the spleen (Figure 2) and multiple abdominal lymph nodes in the upper abdomen.
Grey scale sonography demonstrates multiple oval shaped, hypoechogenic and inhomogeneous lesions in the spleen (spleen metastases)
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F2
Abdominal ultrasound reveals multiple, round, hypoechoic nodules with a maximum diameter located to the renal parenchyma with bilateral involvement (Figure 1), three hypoechoic nodules located inside the spleen (Figure 2) and multiple abdominal lymph nodes in the upper abdomen.
On CEUS scan in the corticomedullary phase, the renal lesion presents a slightly inhomogeneous enhancement with several necrotic areas. b. In venous phase, the lesion reveals no enhancement
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F3
A contrast examination with Sonovue was performed and showed no enhancement for renal and splenic nodules during arterial, venous and late phase which was suggestive for metastatic renal and splenic lesions (Figure 3 and 4).
CEUS shows hypoenhancement of the lesion during the arterial phase. b. Asecond lesion can be seen in the parenchymal phase; both masses demonstrate washout appearance
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F4
A contrast examination with Sonovue was performed and showed no enhancement for renal and splenic nodules during arterial, venous and late phase which was suggestive for metastatic renal and splenic lesions (Figure 3 and 4).
CT after contrast: mediastino-pulmonary mass (blue arrow), esophageal dilation (green arrow), osteolysis of vertebral body T5
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F5
 CT scan showed a large, heterogenous mediastino-pulmonary mass, with encasement of aortic arch and descendent aorta, left pulmonary artery and left principal bronchia and compression of the esophagus and trachea (Figure 5).
CT after contrast: hypoenhanced metastasis of adrenal glands (red arrow), kidney (blue arrow), lymph nodes (green arrow), osteolysis L1 (dark arrow)
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F6
Multiple, bilateral, hypodense postcontrast nodules were seen in kidney and 3 nodules with a diameter of 22, 6 and 7mm respectively were noted inside the spleen (Figure 6).
Reconstruction CT 3D in coronal plane, after contrast-heterogenous mediastino-pulmonary mass, with encasement of middle and posterior mediastinum, with important mass effect to esophagus (much enlarged); hypoenhanced metastases located to the spleen adrenal glands and both kidneys
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F7
Bilateral suprarenal metastases were also recorded and multiple celiac, perigastric and para-aortic lymph nodes were also seen (Figure 7 and 8).
CT after contrast: bilateral, hypoenhanced metastasis of kidney (dark arrow)
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F8
Bilateral suprarenal metastases were also recorded and multiple celiac, perigastric and para-aortic lymph nodes were also seen (Figure 7 and 8).