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Cannonball metastases from renal cell carcinoma

Case contributed by Vikas Shah
Diagnosis certain

Presentation

2 months of cough, shortness of breath and abdominal pain.

Patient Data

Gender: Male

Chest x-ray

x-ray

There are multiple, bilateral, rounded soft tissue density masses on the chest x-ray. There are also moderate sized bilateral pleural effusions, but the mediastinum looks normal, and there are no obvious bony lesions.

CT abdomen and pelvis

ct

This shows a large right sided renal mass, later confirmed to be a renal cell carcinoma.

Case Discussion

The pulmonary lesions have the look of cannonball metastases - the main differential for the causes is metastatic renal cell carcinoma and choriocarcinoma - other causes are much less common.

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