74 year old male patient with right kidney mass and concern for invasion into liver. ABDOMEN:LIVER, BILIARY TRACT: Mass effect on the right hepatic lobe secondary to a large right renal mass as described below. A 1.5 cm T2 hyperintense lesion within the left hepatic lobe without enhancement is compatible with a cyst. Additional subcentimeter T2 hyperintensities are too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The right adrenal gland is not discernible from the right renal mass.KIDNEYS, URETERS: There is a large T2 heterogeneous, enhancing mass arising off the upper pole of the right kidney measuring approximately 8.3 x 6.6 x 11.2 cm (transverse by AP by craniocaudal) with central low intensity compatible with necrotic tumor. Internal foci of increased T1 signal likely represent foci of hemorrhage. The mass extends superiorly and abuts the liver over at least a 7 cm distance. No discrete fat plane is identified on in and out of phase imaging. There is neovascularization of the tumor through recruitment from right intercostal arteries. There is a single right renal artery and vein. No definite right renal vein thrombus. There is a simple left renal cyst.RETROPERITONEUM, LYMPH NODES: There are small retroperitoneal lymph nodes; an aortocaval lymph node measures 1.4 x 0.5 cm (image 66, series 13). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Large necrotic right renal mass compatible with renal cell carcinoma. Extension, abutment, and mass effect of the tumor with the right hepatic lobe without a discrete fat plane is worrisome for invasion.