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Excretory Urography in a 63-Year-Old Man

Sadashiv S. Shenoy, MD

JAMA. 1980;244(12):1373-1374.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

History

A 63-year-old man was admitted with an eight-month history of hypertension, anemia, and bilateral pedal edema. Physical examination revealed a firm mass in the right upper quadrant and bilateral pedal edema. The liver was slightly enlarged.

Laboratory studies disclosed the following values: hemoglobin, 11.2 g/ dL; hematocrit, 33%; urinalysis, negative; lactic dehydrogenase, slightly elevated to 728 µmole/min; and alkaline phosphatase, slightly elevated to 105 µmole/min.

An excretory urogram was obtained (Fig 1).

Diagnosis

Renal carcinoma with invasion and obstruction of the inferior vena cava.

Comment

An excretory urogram shows a mass in the middle and lower poles of the right kidney with distortion of the calices. The lower ureters are medially displaced, and the urinary bladder is pear-shaped with elevation of its base. Nephrotomography showed the renal mass to be solid. The evidence of a solid renal mass with a pear-shaped urinary bladder should suggest renal cell carcinoma invading . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Radiology, the Buffalo General Hospital, and the School of Medicine of the State University of New York at Buffalo.

Footnotes
Reprint requests to Department of Radiology, Buffalo General Hospital, 100 High St, Buffalo, NY 14203 (Dr Shenoy).

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