EURORAD ESR

Case 1985

Renal cell carcinoma and multiple angiomyolipomas in a patient with tuberous sclerosis

Author(s)
V. Kartsouni , G. Steinhauer , M. Pantziara , K. Koutsoubi , B. Mertikopoulos
 
Patient
female, 36 year(s)
 
 
  • Figure 1
    Skull X-ray

    Lateral film of the skull shows a nodular calcification in the parietal region.

     
    Area of Interest: unknown; Imaging Technique: Skull X-ray;
     
     
  • Figure 2
    CT of the brain
     

    Axial CT brain scan without contrast material shows bilateral calcifications in subependymal periventricular hamartomas.

     
    Area of Interest: unknown; Imaging Technique: CT of the brain;

    Subependymal giant cell astrocytoma in the right frontal horn causing hydrocephalus.

     
    Area of Interest: unknown; Imaging Technique: CT of the brain;
     
     
  • Figure 3
    CT of the kidneys
     

    Axial unenhanced CT scan of the kidneys shows a large mass in the inferior pole of the right kidney and multiple small hypodense lesions in both kidneys.

     
    Area of Interest: unknown; Imaging Technique: CT of the kidneys;

    Contrast enhanced CT scan show that the mass has dense contrast enhancement.

     
    Area of Interest: unknown; Imaging Technique: CT of the kidneys;
     
     
  • Figure 4
    Digital subtraction angiography
     

    Selective catheterisation of the anterior branch of the right renal artery.

     
    Area of Interest: unknown; Imaging Technique: Digital subtraction angiography;

    Catheterisation of the aorta above the renal arteries. DSA reveals a very hypervascular mass.

     
    Area of Interest: unknown; Imaging Technique: Digital subtraction angiography;
     
     
  • Figure 5
    Embolisation
     

    Embolisation of the main feeding artery with two metallic coils.

     
    Area of Interest: unknown; Imaging Technique: Embolisation;

    The vascular supply to the mass is reduced.

     
    Area of Interest: unknown; Imaging Technique: Embolisation;
     
     
  • Figure 6
    Surgical specimen

    Gross specimen.

     
    Area of Interest: unknown; Imaging Technique: Surgical specimen;
     
     
  • Figure 7
    Microscopic findings
     

    Focus of angiomyolipoma with surrounding renal parenchyma (x20).

     
    Area of Interest: unknown; Imaging Technique: Microscopic findings;

    Angiomyolipoma with the characteristic features of prominent irregular thick-walled blood vessels surrounded by collarettes of smooth muscle and a background of mature adipose tissue (x200).

     
    Area of Interest: unknown; Imaging Technique: Microscopic findings;

    Renal adenocarcinoma in juxtaposition with the renal pelvis (x20).

     
    Area of Interest: unknown; Imaging Technique: Microscopic findings;

    Solid sheet of renal adenocarcinoma composed of large eosinophilic granular and clear cells showing marked atypia and pleomorphism (x200).

     
    Area of Interest: unknown; Imaging Technique: Microscopic findings;
     
     
Lateral film of the skull shows a nodular calcification in the parietal region.
 
Axial CT brain scan without contrast material shows bilateral calcifications in subependymal periventricular hamartomas.
 
Subependymal giant cell astrocytoma in the right frontal horn causing hydrocephalus.
 
Axial unenhanced CT scan of the kidneys shows a large mass in the inferior pole of the right kidney and multiple small hypodense lesions in both kidneys.
 
Contrast enhanced CT scan show that the mass has dense contrast enhancement.
 
Selective catheterisation of the anterior branch of the right renal artery.
 
Catheterisation of the aorta above the renal arteries. DSA reveals a very hypervascular mass.
 
Embolisation of the main feeding artery with two metallic coils.
 
The vascular supply to the mass is reduced.
 
Gross specimen.
 
Focus of angiomyolipoma with surrounding renal parenchyma (x20).
 
Angiomyolipoma with the characteristic features of prominent irregular thick-walled blood vessels surrounded by collarettes of smooth muscle and a background of mature adipose tissue (x200).
 
Renal adenocarcinoma in juxtaposition with the renal pelvis (x20).
 
Solid sheet of renal adenocarcinoma composed of large eosinophilic granular and clear cells showing marked atypia and pleomorphism (x200).
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version