Differentiation between renal cell carcinoma metastases to the pancreas and pancreatic neuroendocrine tumors in patients with renal cell carcinoma on CT or MRI.

Purpose: To determine whether renal cell carcinoma metastases (RCC-Mets) to the pancreas can be differentiated from pancreatic neuroendocrine tumors (PNETs) in patients with RCC on CT or MRI at presentation.

Methods: This retrospective study included patients with biopsy-proven RCC-Mets (n = 102) or PNETs (n = 32) at diagnosis or after nephrectomy for RCC. Inter-observer agreement (Cohen kappa) was assessed in 95 patients with independent reads by two radiologists, with discrepancies resolved by consensus for final analysis.

Role of MRI in Assessing the Feasibility of Fertility-Sparing Treatments for Early-Stage Endometrial and Cervical Cancers.

Fertility-sparing treatment (FST) has become a key aspect of managing gynecologic cancers in reproductive-age patients who wish to preserve fertility. Several leading clinical societies, including the European Society of Gynecological Oncology, the European Society for Radiotherapy and Oncology, the European Society of Pathology, and the European Society of Human Reproduction and Embryology, have recently published evidence-based guidelines on fertility-sparing strategies and posttreatment surveillance of patients with early-stage gynecologic cancers, in particular endometrial and cervical cancers. These guidelines highlight MRI as essential to initial patient selection and follow-up.

Case 332: Tyrosine Kinase Inhibitor-induced Intestinal Lymphangiectasia.

History A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.

Case 332.

A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.