FDG PET/CT in a Case of Urothelial Carcinoma Arising From a Functional Renal Allograft.
Xiaojun Man, Changming Dong, Aisheng Dong et al.
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Case in brief
Nine years after renal transplantation, a patient with a functional renal allograft was found to have high-grade urothelial carcinoma arising within the graft, with lymph node metastases. FDG PET/CT and contrast-enhanced CT showed an FDG-avid, heterogeneously enhancing renal mass with poorly defined margins, while the kidney retained its reniform shape. Multiple FDG-avid, inhomogeneously enhancing metastases involved ipsilateral internal and external iliac and retroperitoneal lymph nodes.
What made this case unusual
The allograft tumor preserved the kidney’s reniform shape and mimicked centrally located infiltrative renal cell carcinoma on imaging, despite being high-grade urothelial carcinoma.
Diagnostic / clinical pearl
A renal mass in a transplant allograft that resembles infiltrative renal cell carcinoma on imaging may represent urothelial carcinoma; imaging appearance alone may not establish tumor type.