CTICasesMetastatic Renal Cell Carcinoma Presenting as Large Pleural Effusion and Pleural Metastases
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Imaging findings
A patient presented with an opaque left hemithorax and symptoms. Chest X-ray and CT showed a very large left pleural effusion causing significant mediastinal shift to the right. CT also revealed multiple enhancing pleural-based lesions, highly suggestive of metastatic tumor, and possibly some mediastinal/hilar lymphadenopathy. The underlying diagnosis was metastatic renal cell carcinoma.
Key takeaways
Metastatic renal cell carcinoma (RCC) can present dramatically with a large, symptomatic pleural effusion and widespread pleural metastases. The presence of enhancing pleural-based lesions in an oncology patient with a large effusion is strongly suggestive of pleural carcinomatosis. RCC is known for its propensity to metastasize to the pleura, lungs, and mediastinum.
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