Fig. 5
From: Sarcomatoid renal cell carcinoma: MRI features and their association with survival
62-year old man with sarcomatoid RCC with no visible T2LIA. T2-weighted axial image (A) and post-contrast T1-weighted image (B) shows 8.5-cm avidly enhancing left kidney mass (arrows) with large central necrosis (*) but no measurable T2LIA. Baseline work-up revealed no metastatic disease. Radical nephrectomy was done after which pathological analysis showed 8.8-cm clear cell RCC with focal sarcomatoid differentiation and muscular venous branch invasion. After adjuvant treatment with pazopanib, patient developed left lower lobe lung metastasis 670 days after diagnosis and was subsequently treated with multiple lines of systemic treatment including lenvatinib, pembrolizumab, and nivolumab. Patient is still alive after 3397 days