Radiological, pathological and gross correlation of an isolated renal cell carcinoma metastasis to the stomach

Description

A 59-year-old asymptomatic woman presented for follow-up CT thorax, abdomen and pelvis (CT-TAP). Fifteen months previously she underwent a left radical nephrectomy for a T1bN0MO, 5.5 cm Fuhrman grade 4 clear cell renal cell carcinoma (CCRCC) (figure 1).

Figure 1

Portal venous phase coronal image CT-TAP. The 6.8 cm expansile, heterogenous lesion is centred in the renal cortex of the mid/upper pole of the left kidney (yellow circle). It appears well encapsulated (red arrows) and abuts the renal sinus with no clear invasion. The low attenuation may be due to necrosis or cystic components. CT-TAP, CT thorax, abdomen and pelvis.

The CT-TAP revealed a new 3.6 cm peripherally enhancing, centrally necrotic, intramural lesion in the fundus of the stomach (figure 2). It was decided to biopsy the lesion via oesophago-gastro duodenoscopy (OGD). It was not apparent on direct visualisation of the stomach mucosa, thus...

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