PMC6398077_01
Initial imaging studies. Left: renal ultrasound at presentation revealed moderately enlarged kidneys with increased renal cortical echogenicity and mild bilateral hydronephrosis. Right: abdomen and pelvis computed tomogram without contrast revealed mild inflammatory changes without lymphadenopathy.
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Renal ultrasound and abdomen/pelvis CT without contrast revealed mild bilateral hydroureteronephrosis with nonspecific inflammatory changes (Figure 1).
Abdomen and pelvis computed tomogram with intravenous contrast revealed mild bilateral hydroureteronephrosis with point of obstruction at the level of distal abdominal aorta and inferior vena cava. There was an ill-defined, infiltrative soft tissue mass encasing both aorta and IVC (approximately 7.2 cm). The mass appeared to infiltrate along the bilateral proximal common iliac vessels.
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The mass appeared to infiltrate along the bilateral proximal common iliac vessels (Figure 2).
Follow-up abdomen and pelvis computed tomogram with and without intravenous contrast 4 months following a course of corticosteroid therapy revealed significant reduction in the soft tissue mass (approximately 4 cm in diameter compared with 7 cm at presentation).
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At 4-month follow-up, kidney function normalized and CT revealed marked reduction in RPF size (Figure 3).