radiological evaluation of renal cell carcinoma

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1、TeresaKim,HMSIIINovember2006GillianLieberman,MDRadiologicEvaluationofRenalCellCarcinomaTeresaKim,HarvardMedicalSchoolYearIIIGillianLieberman,MDTeresaKim,HMSIIINovember2006GillianLieberman,MDObjectivesOurpatient:InitialpresentationDifferentialdiagnosis:SolidrenalmassBac

2、kground:Renalcellcarcinoma(RCC)ImagingRCC:Menuoftests,keyfindingsOurpatient:Follow-upSummary2TeresaKim,HMSIIINovember2006GillianLieberman,MDObjectivesOurpatient:InitialpresentationDifferentialdiagnosis:SolidrenalmassBackground:Renalcellcarcinoma(RCC)ImagingRCC:Menu

3、oftests,keyfindingsOurpatient:Follow-upSummary3TeresaKim,HMSIIINovember2006GillianLieberman,MDOurPatient:InitialPresentationCC:Ms.K.isa60yowomanw/newbackpain,unresponsivetoconservativetherapynoww/painradiatingdownbothlegs+LEweakness.Nextstep:MRIofL-spinew/unexpectedf

4、inding!4TeresaKim,HMSIIINovember2006GillianLieberman,MDOurPatient:InitialMRIL-spineSagittalpre-contrastT1WMRI:L1vertebralSagittalT2WMRI:bodyw/moderate-severecompressionfractureRetropulsionofosseousfragmentsintospinalcanal,impingingonspinalcordImagescourtesyofDr.JasonHandw

5、erker,BIDMC5TeresaKim,HMSIIINovember2006GillianLieberman,MDOurPatient:InitialMRIL-spineIntactthoracicvertebralbody,AxialT2WMRIatL1:ScoutMRI:superiortoL1lesionCollapsedL1Softtissuemassw/epidural,LparaspinalextensionLargesofttissuemassSpinalcanalinLrenalfossastenosisImagesc

6、ourtesyofDr.JasonHandwerker,BIDMC6TeresaKim,HMSIIINovember2006GillianLieberman,MDOurPatient:InitialPresentation2Problems:1.Largerenalmass2.Vertebralbodycompressionfracture7TeresaKim,HMSIIINovember2006GillianLieberman,MDOurPatient:InitialPresentation2Problems:1.Larger

7、enalmassNextstep?2.Vertebralbodycompressionfracture8TeresaKim,HMSIIINovember2006GillianLieberman,MDObjectivesOurpatient:InitialpresentationDifferentialdiagnosis:SolidrenalmassBackground:Renalcellcarcinoma(RCC)ImagingRCC:Menuoftests,keyfindingsOurpatient:Follow-upS

8、ummary9TeresaKim,HMSIIINovember2006GillianLieberman,MDApproachtoaRenalMassBeforereviewingthedif