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Click Initial CT scan. 51-year-old female with left renal neuroectodermal tumor. Contrast enhanced CT of the abdomen acquired during the cortical phase. There is a large, lobulated mass involving the upper and inter-polar region of the left kidney, which shows hypervascular enhancement. The mass does not extend beyond the perirenal fascia. There is extension of the mass into the left renal vein, but does not cross the midline. This thrombus enhances, consistent with tumor thrombus. There is no involvement of the IVC.

Click Left Renal Artery Angiogram 51-year-old female with left renal neuroectodermal tumor. Visceral angiogram performed via a right common femoral artery approach, and using a 5FR sheath, a 5Fr Simmons 1 catheter was used to select and inject the left main renal artery. The left kidney is enlarged and is nearly completely replaced by a hypervascular mass that displays tumor vascularity.

Click 51-year-old female with left renal neuroectodermal tumor. Post Embolization Angiogram. Following selective embolization of the mass using 200-300 micron PVA, angiogram through the Simmons 1 catheter placed in the left main renal artery shows markedly decreased flow to the entire renal mass.

Click Post Embolization CT. 51-year-old female with left renal neuroectodermal tumor following selective embolization.Contrast enhanced CT of the abdomen acquired during the nephrographic phase. CT of the abdomen performed 2 weeks following selective embolization shows marked decreased in enhancement of the mass, with a thin, peripheral enhancing rim of the tumor from capsular vessels, with tiny pockets of gas secondary to necrosis. There is a thrombus within the left renal vein, which shows enhancement, consistent with tumor thrombus.