Which radiographic findings are characteristic of renal cell carcinoma (RCC)?

Updated: Dec 13, 2018
  • Author: Deborah A Baumgarten, MD, MPH; Chief Editor: Eugene C Lin, MD  more...
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Plain radiographic findings often are unrevealing in patients with renal cell carcinoma, unless the mass contains detectable calcification or is large enough to distort the normal renal contour. Plain radiography has no role in the primary search for RCC or in the follow-up observation of patients with RCC because of its limited sensitivity and specificity.

Intravenous urography (IVU) is also limited in depicting RCCs. Large lesions, which can distort the renal contour or the collecting system, may be detected with IVU. If RCC is suggested, further imaging with CT or MRI is necessary to confirm a solid mass and to stage the disease. If the lesion appears to be a cyst, US is the next best test in the patient's workup.

Findings of RCC are nonspecific and include mass effect on the collecting system, distortion of the renal contour, enlargement of a portion of the kidney, and calcifications. If good nephrotomograms are obtained at peak renal enhancement, most RCCs are less attenuating than surrounding renal parenchyma. Renal vein invasion may be inferred if contrast material excretion by the affected kidney is poor or absent. Alternatively, this finding may result from extensive involvement of the kidney or ureteral obstruction caused by mass effect.

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