5-17 quiz CT renal mass nodal metastasis
(A) Coronal cut from a post-contrast computed tomography scan demonstrating a left-enhancing renal mass and an isolated paraaortic nodal metastasis abutting the renal hilum.
5-17 quiz CT renal mass nodal metastasis #2
(B) axial cut from a post-contrast computed tomography scan demonstrating a left-enhancing renal mass and an isolated paraaortic nodal metastasis abutting the renal hilum.
A 57-year-old woman presents with a 6 cm left-enhancing renal mass and an isolated 2.5 cm pathologic hilar lymph node. The patient elects to undergo a nephrectomy and lymphadenectomy.
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This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.
1. Gershman B, Moreira DM, Thompson RH, et al. Renal cell carcinoma with isolated lymph node involvement: Long-term natural history and predictors of oncologic outcomes following surgical resection. Eur Urol 2017 (published online ahead of print).
Answer A: Boris Gershman, MD, and colleagues recently reported on long-term follow up in patients with resected isolated nodal metastases at the time of nephrectomy. In a series of 138 patients, the 10-year metastasis-free survival was only 15%. Median time to metastatic disease was 4.2 months.1