Abstract

We describe the computed tomographic (CT) and magnetic resonance imaging (MRI) features of a very rare renal neoplasm, a glomus tumor. Our patient was a 68-year-old woman with a history of high grade T1 stage bladder cancer, status post intravesical Bacillus Calmette-Guérin (BCG) therapy and left ureteral stent placement, who presented for routine follow-up imaging evaluation of the urothelial tract. Computed tomographic urography (CTU) incidentally demonstrated a 1.7 cm well-circumscribed, non-calcified, non-fat containing lesion in the left renal cortex with arterial phase continuous peripheral rim enhancement and central hypoattenuation relative to enhanced renal parenchyma. Subsequent MRI showed the lesion to be isointense in signal intensity relative to the renal parenchyma on T1-weighted imaging and hyperintense on T2-weighted imaging. No macroscopic fat or microscopic lipid was seen within the lesion, and there were no foci of susceptibility artifact on T1-weighted images. Diffusion-weighted and apparent diffusion coefficient images demonstrated no restricted diffusion. Contrast-enhanced images demonstrated continuous peripheral rim enhancement in the arterial phase and persistent rim enhancement with partial centripetal fill in of enhancement on venous phase images, similar to the pattern seen on CT. Partial left nephrectomy was performed for the suspected solid renal neoplasm. Histopathological assessment was diagnostic of a renal glomus tumor.

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