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Renal Cell Carcinoma
Brad Perry, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Renal cell carcinoma (RCC): Carcinoma of renal tubular epithelium
                • Commonly located in renal cortex
                • Exophytic
                  • Originates from lining of proximal convoluted tubule
                • Can be bilateral (2%)
                  • Especially individuals with genetic syndromes (von Hippel-Lindau)
                • 10% calcified, often irregular
                • 2-5% cystic

            IMAGING

            • F-18 FDG PET/CT Findings

              • Ga-68 PSMA PET/CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • CT Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. ACR Appropriateness Criteria: renal cell carcinoma staging. Agency for Healthcare Research and Quality, National Guideline Clearinghouse. http://www.guideline.gov/content.aspx?id=35153. Accessed September 24, 2014
                                        2. Rhee H et al: Pilot study: use of gallium-68 PSMA PET for detection of metastatic lesions in patients with renal tumour. EJNMMI Res. 6(1):76, 2016
                                        3. Demirci E et al: (68)Ga-PSMA PET/CT imaging of metastatic clear cell renal cell carcinoma. Eur J Nucl Med Mol Imaging. 41(7):1461-2, 2014
                                        4. Nakatani K et al: The potential clinical value of FDG-PET for recurrent renal cell carcinoma. Eur J Radiol. 79(1):29-35, 2011
                                        5. Kumar R et al: Role of FDG PET-CT in recurrent renal cell carcinoma. Nucl Med Commun. 31(10):844-50, 2010
                                        6. Oliva MR et al: Renal cell carcinoma: t1 and t2 signal intensity characteristics of papillary and clear cell types correlated with pathology. AJR Am J Roentgenol. 192(6):1524-30, 2009
                                        7. Lawrentschuk N et al: Positron emission tomography (PET), immuno-PET and radioimmunotherapy in renal cell carcinoma: a developing diagnostic and therapeutic relationship. BJU Int. 97(5):916-22, 2006
                                        8. Ak I et al: F-18 FDG PET in detecting renal cell carcinoma. Acta Radiol. 46(8):895-9, 2005
                                        9. Ide M et al: The detection of renal cell carcinoma with adrenal and para-aortic lymph node metastases by FDG-PET. Eur J Nucl Med Mol Imaging. 32(10):1246, 2005
                                        10. Nguyen BD: Positron emission tomography imaging of renal vein and inferior vena cava tumor thrombus from renal cell carcinoma. Clin Nucl Med. 30(2):107-9, 2005
                                        11. Cheow HK et al: Large renal cell carcinoma isometabolic with normal liver on F-18 FDG PET scan. Clin Nucl Med. 29(8):488-90, 2004
                                        12. Kang DE et al: Clinical use of fluorodeoxyglucose F 18 positron emission tomography for detection of renal cell carcinoma. J Urol. 171(5):1806-9, 2004
                                        13. Schoder H et al: Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med. 34(4):274-92, 2004
                                        14. Watanabe N et al: A case of renal pelvic tumor visualized by 18F-FDG-PET imaging. Ann Nucl Med. 18(2):161-3, 2004
                                        15. Jadvar H et al: Diagnostic role of [F-18]-FDG positron emission tomography in restaging renal cell carcinoma. Clin Nephrol. 60(6):395-400, 2003
                                        16. Shvarts O et al: Positron emission tomography in urologic oncology. Cancer Control. 9(4):335-42, 2002
                                        17. Hoh CK et al: Positron emission tomography in urological oncology. J Urol. 159(2):347-56, 1998
                                        18. Koga S et al: The diagnostic value of bone scan in patients with renal cell carcinoma. J Urol. 166(6):2126-8, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Renal cell carcinoma (RCC): Carcinoma of renal tubular epithelium
                                                      • Commonly located in renal cortex
                                                      • Exophytic
                                                        • Originates from lining of proximal convoluted tubule
                                                      • Can be bilateral (2%)
                                                        • Especially individuals with genetic syndromes (von Hippel-Lindau)
                                                      • 10% calcified, often irregular
                                                      • 2-5% cystic

                                                  IMAGING

                                                  • F-18 FDG PET/CT Findings

                                                    • Ga-68 PSMA PET/CT Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • CT Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. ACR Appropriateness Criteria: renal cell carcinoma staging. Agency for Healthcare Research and Quality, National Guideline Clearinghouse. http://www.guideline.gov/content.aspx?id=35153. Accessed September 24, 2014
                                                                              2. Rhee H et al: Pilot study: use of gallium-68 PSMA PET for detection of metastatic lesions in patients with renal tumour. EJNMMI Res. 6(1):76, 2016
                                                                              3. Demirci E et al: (68)Ga-PSMA PET/CT imaging of metastatic clear cell renal cell carcinoma. Eur J Nucl Med Mol Imaging. 41(7):1461-2, 2014
                                                                              4. Nakatani K et al: The potential clinical value of FDG-PET for recurrent renal cell carcinoma. Eur J Radiol. 79(1):29-35, 2011
                                                                              5. Kumar R et al: Role of FDG PET-CT in recurrent renal cell carcinoma. Nucl Med Commun. 31(10):844-50, 2010
                                                                              6. Oliva MR et al: Renal cell carcinoma: t1 and t2 signal intensity characteristics of papillary and clear cell types correlated with pathology. AJR Am J Roentgenol. 192(6):1524-30, 2009
                                                                              7. Lawrentschuk N et al: Positron emission tomography (PET), immuno-PET and radioimmunotherapy in renal cell carcinoma: a developing diagnostic and therapeutic relationship. BJU Int. 97(5):916-22, 2006
                                                                              8. Ak I et al: F-18 FDG PET in detecting renal cell carcinoma. Acta Radiol. 46(8):895-9, 2005
                                                                              9. Ide M et al: The detection of renal cell carcinoma with adrenal and para-aortic lymph node metastases by FDG-PET. Eur J Nucl Med Mol Imaging. 32(10):1246, 2005
                                                                              10. Nguyen BD: Positron emission tomography imaging of renal vein and inferior vena cava tumor thrombus from renal cell carcinoma. Clin Nucl Med. 30(2):107-9, 2005
                                                                              11. Cheow HK et al: Large renal cell carcinoma isometabolic with normal liver on F-18 FDG PET scan. Clin Nucl Med. 29(8):488-90, 2004
                                                                              12. Kang DE et al: Clinical use of fluorodeoxyglucose F 18 positron emission tomography for detection of renal cell carcinoma. J Urol. 171(5):1806-9, 2004
                                                                              13. Schoder H et al: Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med. 34(4):274-92, 2004
                                                                              14. Watanabe N et al: A case of renal pelvic tumor visualized by 18F-FDG-PET imaging. Ann Nucl Med. 18(2):161-3, 2004
                                                                              15. Jadvar H et al: Diagnostic role of [F-18]-FDG positron emission tomography in restaging renal cell carcinoma. Clin Nephrol. 60(6):395-400, 2003
                                                                              16. Shvarts O et al: Positron emission tomography in urologic oncology. Cancer Control. 9(4):335-42, 2002
                                                                              17. Hoh CK et al: Positron emission tomography in urological oncology. J Urol. 159(2):347-56, 1998
                                                                              18. Koga S et al: The diagnostic value of bone scan in patients with renal cell carcinoma. J Urol. 166(6):2126-8, 2001