The complete echographic evaluation of solid renal masses

In the presence of a solid intrarenal mass, ultrasound scans should not be limited to the mass itself. Modern commercial gray scale equipment is capable of demonstrating both tumor extension into the inferior vena cava and the metastatic disease to the liver. The presence of multiple solid intrarenal masses favors the diagnosis of metastatic disease to the kidney or multiple angiomyolipomas. Retroperitoneal lymphadenopathy or an adrenal mass coincidental with an intrarenal mass suggests metastatic disease. These possibilities can be detected by echography if prone scans are performed over the suprarenal region and the contralateral kidney, and supine scans are performed for evaluation of the inferior vena cava, liver, and retroperitoneum.