We present a case, pathologically proven, of a patient with multiple papillary renal cell carcinoma (PRCC) with bilateral and synchronous affectation. CT showed fatty tissue inside one of the lesions and numerous calcified lesions. The study with MR demonstrated multiple and hypointense lesions in T2 and contrast enhancement in T1. Our observations confirm that the presence of multiple lesions with fat and calcified deposits and poor contrast enhancement should be diagnosed as PRCC, rather than renal clear cell carcinoma (RCCC) or renal angiomyolipoma.
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