Ultrasound: In the right kidney there is a large solid mass with heterogenous echotexture and internal vascularity.
CT: The mass is well-circumscribed, lobulated, somewhat heterogenous with a central stellate hypoattenuation. Otherwise it is isoattenuating relative to renal parenchyma on non-contrast and hypoenhancing relative to renal parenchyma on nephrographic phase relative to renal parenchyma (corticomedullary phase not performed).
MRI: MRI was only performed to confirm the absence of renal vein involvement (not shown).
T2: The central stellate scar is T2 hyperintense and does not enhance on nephrographic phase.
T1 in and out of phase do not demonstrate chemical shift artifact (i.e. no microscopic fat).
On DWI (B value = 600) and ADC there is T2 shine through of the central scar and the periphery of the mass restricts less than renal cortex.
Corticomedullary and nephrographic phase post-gadolinium T1 subtraction images demonstrate mild enhancement.