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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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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