What is the role of imaging studies in the workup of clear cell renal cell carcinoma (CCRCC)?

Updated: Mar 11, 2019
  • Author: Ronald J Cohen, MB, BCh, PhD, FRCPA, FFPATH; Chief Editor: Liang Cheng, MD  more...
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Answer

Answer

Although ultrasonography is commonly involved in the detection of renal cell carcinoma (RCC), CT or magnetic resonance imaging (MRI) is better suited for determining detailed staging information, and contrast-enhanced biphasic or triphasic helical CT also has some value in preoperative distinction between histologic subtypes of RCC. [33]

A mixed enhancement pattern of both high-attenuation hypervascular soft-tissue components and low-attenuation areas indicative of necrotic or cystic changes is highly predictive of clear cell renal cell carcinoma (CCRCC) (80-90% of cases), compared with other RCC subtypes. However, this pattern is also seen in a considerable proportion (40-60%) of benign oncocytomas. [34]

Imaging studies of CCRCC have shown that extensive cystic degeneration with associated necrosis occurs in less than 15% of cases, [35] whereas focal cystic necrosis is relatively common. Focal calcification can be seen in 11-26% of CCRCCs, [34, 36, 37] and ossification may also be present in rare cases. [38]

Go to Imaging of Renal Cell Carcinoma for more complete information on this topic.


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