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Renal Medullary Carcinoma: CT and MRI Features

Netta M. Blitman1, Robert G. Berkenblit2, Alla M. Rozenblit2 and Terry L. Levin1

1 Department of Radiology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, 3400 Bainbridge Ave., Bronx, NY 10467.
2 Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467.



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  		Fig. 1A —17-year-old boy with renal medullary carcinoma. CT image shows right upper pole renal medullary carcinoma. Mass (arrow) is infiltrative, and kidney retains its reniform shape.

 


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  		Fig. 1B —17-year-old boy with renal medullary carcinoma. Photograph shows gross pathologic specimen. Ruler shows measurement in cm.

 


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  		Fig. 2A —20-year-old man with renal medullary carcinoma. CT image obtained with contrast material shows infiltrative mass (black arrow) and subcapsular hematoma (white arrow) indenting substance of kidney. Regional adenopathy (arrowhead) is present.

 


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  		Fig. 2B —20-year-old man with renal medullary carcinoma. Axial 3D fat-suppressed gradient-echo MR image (TR/TE, 4.5/1.1) obtained with contrast material at same level as A shows renal artery and vein separated by adenopathy (arrowhead). Right renal artery is encased.

 


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  		Fig. 2C —20-year-old man with renal medullary carcinoma. Coronal 3D fat-suppressed gradient-echo MR image (4.5/1.1) obtained with contrast material shows extent of adenopathy (arrow) is better assessed on MRI than CT (A).

 


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  		Fig. 3A —15-year-old girl with renal medullary carcinoma. Sonogram shows increased medullary echogenicity. No discrete mass is identified.

 


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  		Fig. 3B —15-year-old girl with renal medullary carcinoma. CT scan obtained 2 days after A shows distinct infiltrative mass (lower arrow), and caliectasis (upper arrow). Right paraaortic adenopathy (arrowheads) displaces the renal artery.

 


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  		Fig. 3C —15-year-old girl with renal medullary carcinoma. Delayed contrast-enhanced T1-weighted spin-echo MR image (TR/TE, 506/12) at slightly higher level than B shows similar features. Arrow denotes tumor.

 


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  		Fig. 4A —27-year-old man with renal medullary carcinoma. Axial CT scan shows multilocular right renal lesion without visible hemorrhage. Note subtle metastatic liver lesion (arrow).

 


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  		Fig. 4B —27-year-old man with renal medullary carcinoma. T2-weighted fast spin-echo fat-saturation MR image (TR/TE, 2,500/96) comparable to A shows hypointense hemosiderin rim and central hypointense septations, which is consistent with chronic hemorrhage (arrowheads). Note also conspicuity of liver metastasis (arrow) is increased on MRI as compared with CT (A).

 

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