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Imaging in Metastatic Renal Cell Carcinoma

Nyree Griffin1, Martin E. Gore2 and S. Aslam Sohaib1

1 Department of Diagnostic Imaging, Royal Marsden Hospital, 203 Fulham Rd., London SW3 6JJ, United Kingdom.
2 Department of Medical Oncology, Royal Marsden Hospital, London, United Kingdom.


Figure 1
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  		Fig. 1 —76-year-old man with typical lung metastases from renal cancer on CT.

 

Figure 2
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  		Fig. 2A —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). Contrast-enhanced CT scans before treatment show rib metastasis (arrow, A), metastasis in intercostal muscle (arrow, B), and multiple small pulmonary metastases (arrows, C).

 

Figure 3
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  		Fig. 2B —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). Contrast-enhanced CT scans before treatment show rib metastasis (arrow, A), metastasis in intercostal muscle (arrow, B), and multiple small pulmonary metastases (arrows, C).

 

Figure 4
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  		Fig. 2C —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). Contrast-enhanced CT scans before treatment show rib metastasis (arrow, A), metastasis in intercostal muscle (arrow, B), and multiple small pulmonary metastases (arrows, C).

 

Figure 5
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  		Fig. 2D —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). After treatment CT scans show bone metastasis has reduced in size (arrow, D), soft-tissue metastases in intercostal space have resolved (E), and pulmonary metastases have resolved (F).

 

Figure 6
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  		Fig. 2E —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). After treatment CT scans show bone metastasis has reduced in size (arrow, D), soft-tissue metastases in intercostal space have resolved (E), and pulmonary metastases have resolved (F).

 

Figure 7
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  		Fig. 2F —55-year-old woman with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). After treatment CT scans show bone metastasis has reduced in size (arrow, D), soft-tissue metastases in intercostal space have resolved (E), and pulmonary metastases have resolved (F).

 

Figure 8
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  		Fig. 3A —61-year-old woman with metastatic renal cell cancer. Contrast-enhanced CT scans show enlarged pretracheal lymph node (arrow, A) and pancreatic metastases (arrows, B).

 

Figure 9
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  		Fig. 3B —61-year-old woman with metastatic renal cell cancer. Contrast-enhanced CT scans show enlarged pretracheal lymph node (arrow, A) and pancreatic metastases (arrows, B).

 

Figure 10
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  		Fig. 4A —63-year-old man with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). Contrast-enhanced CT scans before treatment show large enhancing liver metastasis (arrow, A) and disease in right renal bed (arrow, B).

 

Figure 11
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  		Fig. 4B —63-year-old man with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). Contrast-enhanced CT scans before treatment show large enhancing liver metastasis (arrow, A) and disease in right renal bed (arrow, B).

 

Figure 12
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  		Fig. 4C —63-year-old man with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). After treatment, CT scans show reduction in density and size of liver metastasis (arrow, C) and decrease in size of mass (arrow, D) in renal bed.

 

Figure 13
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  		Fig. 4D —63-year-old man with metastatic renal cell cancer undergoing treatment with sunitinib (tyrosine kinase inhibitor). After treatment, CT scans show reduction in density and size of liver metastasis (arrow, C) and decrease in size of mass (arrow, D) in renal bed.

 

Figure 14
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  		Fig. 5A —60-year-old man with retroperitoneal lymphadenopathy (arrow). Contrast-enhanced CT scan before treatment with sunitinib (tyrosine kinase inhibitor) shows metastasis (arrow).

 

Figure 15
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  		Fig. 5B —60-year-old man with retroperitoneal lymphadenopathy (arrow). After two cycles of therapy, scan shows decrease in attenuation of lymph node but little change in size of lesion (arrow).

 

Figure 16
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  		Fig. 6A —59-year-old man with metastatic renal cell cancer. Contrast-enhanced CT scans show metastasis (arrows, A) to spleen, which is enlarged, and metastasis (arrow, B) to umbilicus.

 

Figure 17
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  		Fig. 6B —59-year-old man with metastatic renal cell cancer. Contrast-enhanced CT scans show metastasis (arrows, A) to spleen, which is enlarged, and metastasis (arrow, B) to umbilicus.

 

Figure 18
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  		Fig. 7A —18-year-old woman with metastatic renal cell cancer. Contrast-enhanced CT scans show peritoneal metastasis (arrow, A) and bone metastasis (arrow, B) in right ileum.

 

Figure 19
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  		Fig. 7B —18-year-old woman with metastatic renal cell cancer. Contrast-enhanced CT scans show peritoneal metastasis (arrow, A) and bone metastasis (arrow, B) in right ileum.

 

Figure 20
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  		Fig. 8A —Fluorine-18-FDG PET CT in 61-year-old man with recurrent renal cancer. CT image shows soft-tissue disease in left posterior abdominal wall (arrow).

 

Figure 21
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  		Fig. 8B —Fluorine-18-FDG PET CT in 61-year-old man with recurrent renal cancer. Fused PET/CT image shows increased activity in left posterior abdominal wall (arrow) corresponding to soft-tissue disease.

 

Figure 22
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  		Fig. 9 —41-year-old woman with brain metastases. Coronal T1-weighted image after IV contrast enhancement with gadolinium shows multiple enhancing lesions (arrows).

 

Figure 23
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  		Fig. 10A —62-year-old man with thyroid metastases (arrow). Contrast-enhanced CT scan before treatment with sunitinib (tyrosine kinase inhibitor) shows metastasis (arrow).

 

Figure 24
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  		Fig. 10B —62-year-old man with thyroid metastases (arrow). Scan after drug therapy shows thyroid metastases are smaller and of lower density (arrow).

 

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