PMC5439060_01
On contrasted CT, 80 mm x 76 mm renal mass with heterogeneous contrast enhancement arising from the lower pole of the right kidney.
CRIS2017-9849205.001.jpg
PMC5439060_01_CRIS2017-9849205.001.jpg
fig1
Computed tomographic (CT) examinations performed on the patient with a history of renal calculi revealed 80 mm x 76 mm renal mass arising from the lower middle pole of the right kidney and demonstrating a heterogeneous contrast uptake (Figure 1).
On contrasted MR a lesion measuring nearly 58 mm x 68 mm cyst with an increased signal intensity (30 HU), which fills Douglas recess and extends into the left adnexa. Initially the lesion was thought to be a left ovarian cyst but histopathology report demonstrated a metastatic lesion of renal clear-cell carcinoma with dimensions of 70 mm x 50 mm x 50 mm.
CRIS2017-9849205.002.jpg
PMC5439060_01_CRIS2017-9849205.002.jpg
fig2
CA 15-3: 22.5 U/mL, CA 19-9: 8.3 U/mL, and CEA 2.09 ng/mL]. Cervicovaginal smear cytology results were negative for dysplasia and malignancy. Contrast-enhanced computed tomography revealed a nearly 58 mm x 68 mm cystic mass with high signal intensity (30 HU), which filled the entire Douglas recess, and extended up to the left adnexa which was initially thought to be a left ovarian cyst (Figure 2).
Renal cell carcinoma closer to the pelvic cavity observed under small magnification (H&E x40).
CRIS2017-9849205.003.jpg
PMC5439060_01_CRIS2017-9849205.003.jpg
fig3
Histopathology report demonstrated a metastatic lesion of renal clear-cell carcinoma with dimensions of 70 mm x 50 mm x 50 mm, paratubal cyst, and hyperemia (Figure 3).