Fig. 7
From: Multidetector CT imaging of complications after laparoscopic nephron-sparing surgery
Postoperative gross haematuria in a 55-year-old man 5 weeks after enucleation of a left-sided, 3.7-cm, pT1a clear-cell RCC including the calyceal opening. Unenhanced CT images revealed a 4.5-cm, inhomogeneous, roundish renal mass (arrowheads) with non-dependent hyperattenuating material (+), suggesting thrombus. After intravenous contrast, corticomedullary (b, c) and nephrographic (d) CT images showed perfusion (*) synchronous to arterial vessels of most of the same lesion, consistent with pseudoaneurysm. Renal angiography (e) confirmed roundish lesion (arrow) occupied by haemorrhagic focus (*) from the distal portion of the anteromedial branch, corresponding to the site of recent tumour excision. Super selective catheterisation and embolisation with coils (f) allowed the bleeding to be stopped