Clear Cell Renal Cell Carcinoma (ccRCC): Imaging Diagnosis, MRI Hallmarks, Differential Diagnosis, and Modern Treatment
Imaging Diagnosis, MRI Hallmarks, Differential Diagnosis, and Modern Treatment Clear cell renal cell carcinoma ( clear cell RCC, ccRCC ) is the most common malignant tumor of the kidney and a leading cause of cancer-related mortality in urologic oncology. In contemporary clinical practice, ccRCC is increasingly detected incidentally during imaging performed for unrelated indications—often before classic symptoms arise. This early detection has transformed the diagnostic workflow into an imaging-centered pathway, where radiologists and clinicians rely heavily on multiphasic CT and multiparametric MRI to characterize renal masses, stratify malignancy risk, and guide staging and treatment planning. In this column, I present a representative case of ccRCC discovered on surveillance imaging in an elderly former smoker, with subsequent MRI demonstrating hallmark features including heterogeneous T2 hyperintensity, signal drop on chemical shift imaging consistent with intracellular lipid...