Case Challenge

Genitourinary (GU)

Kidneys

Stephen J Pomeranz

Gain confidence interpreting Renal Masses with practice cases from MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Body

Case 1 - 57-year-old female presents with history of right renal mass

Case 2 - 40-year-old male presents with a right renal mass

Case 3 - 47-year-old male presents with right renal mass and left adrenal nodule

Case 4 - 65-year-old male presents with history of exophytic lesion

Case 5 - 53-year-old female presents with history of kidney stones

Case 6 - 43-year-old female presents with renal mass

Case 7 - 5-year-old female presents with right renal mass

Case 8 - 6-year-old male presents with tumor, evaluate horseshoe kidney

Case 9 - 72-year-old female presents with renal mass

Case 10 - 60-year-old male presents with right renal mass

Case 11 - 55-year-old male presents with abnormal findings of the right kidney

Case 12 - 82-year-old female presents with dorsalgia, back pain

Case 13 - 50-year-old male presents with bilateral low back pain

Case 14 - 29-year-old male has had benign tumors removed from eyes and kidneys

Case 15 - 55-year-old female should be evaluated for neoplasm of the liver

Case 16 - 64-year-old female presents with right renal mass

Case 17 - 76-year-old female presents with history of adrenal abnormality

Case 18 - 69-year-old female referred for MRI subsequent to moderate symptoms from kidneys

Case 19 - 91-year-old male presents with history of chronic kidney disease

Case 20 - 67-year-old female presents with low back pain and left flank pain

Case 21 - 49-year-old male presents with renal mass

Case 22 - 64-year-old female presents with history of kidney stones and renal mass

Case 23 - 78-year-old female presents with left renal mass

Case 24 - 70-year-old female presents with left renal mass

Case 25 - 72-year-old male presents with left renal mass

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Renal Masses MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Renal Masses Cases

<div>HISTORY:&#160;This 64-year-old female presents with history of kidney stones and renal mass.(QUIZ ANSWER) WHICH IS FAVORED IN THIS CASE:&#160;Renal cell carcinoma is favored over angiomyolipomaUsing the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:&#160;The enhancing nodule in the posterior lateral mid pole cortex of the left kidney is larger, now measuring 2.1 x 1.9 cm, previously measuring 1.2 x 1.1 cm (two years prior).&#160;This does lose some signal on out of phase images suggesting some fat component.&#160;However, given the enlargement, renal cell carcinoma is favored over angiomyolipoma.Other small subcentimeter renal cysts are present.&#160;No hydronephrosis.&#160;No large obstructing stones seen.&#160;Small renal calculi not optimally visualized by MRI.Fatty infiltration of the liver is present.&#160;Previously described nodule in the inferior right lobe of the liver is slightly larger, now measuring 1.9 x 1.7 cm, previously approximately 1.2 x 1.1 cm (two years prior).&#160;Nodule is well demarcated and T2 bright with diffuse enhancemint following contrast except for a tiny focus medially.&#160;Appearance would be most consistent with flash fill hemangioma although hepatic adenoma or focal nodular hyperplasia possible.&#160;Malignancy less likely.&#160;However, given the interval enlargement, close follow-up recommended, unless otherwise clinically indicated.No other liver lesions.The spleen, adrenal glands, gallbladder, pancreas normal.&#160;A very small hiatal hernia present.No abdominal aortic aneurysm or retroperitoneal adenopathy.No bowel obstruction.CONCLUSION:1. Interval enlargement of enhancing nodule posterolateral mid pole cortex of left kidney, now measuring 2.1 x 1.9 cm. This does contain fat, but given the growth appearance is concerning for renal cell carcinoma rather than angiomyolipoma.2. A enhancing nodule in the inferior right lobe of liver is also larger.&#160;Flash fill hemangioma, hepatic adenoma or focal nodular hyperplasia still favored over malignancy.&#160;However, close interval follow-up recommended, unless otherwise clinically indicated.</div>

Case

Renal cell carcinoma is favored over angiomyolipoma

Angiomyolipoma is favored over renal cell carcinoma

There is an enhancing nodule in the posterior lateral mid pole cortex of the left kidney that is larger (now measuring 2.1 x 1.9 cm) than previously measured (1.2 x 1.1 cm) two years prior. This does lose some signal on out of phase images suggesting some fat component. However, given the enlargement, which would be favored?