Figure 2. Translocation RCC in a 13-year-old boy (patient 6 in Tables 1–2) with internal gross hematuria and a left cervical mass (biopsy proved metastases).

A–C, Axial T2WI and plain (non-contrast) T1WI (B, IP; C, OP) showing a large, ill-defined, irregular mass (T2, high-low mixed signal intensity; T1, iso-high mixed signal intensity; liquid-gas surface) with a large, patchy hemorrhage and necrosis in the center of the left renal mass, without an integrated capsule. Multiple retroperitoneal metastases are detected. D–E, CMP and NP gradient-echo MR images showing marked enhancement, predominantly in the periphery of the mass. F, Coronal delay phase image showing marked enhancement in the periphery of the mass, invading the left renal pelvic space and vessels. G, The tumor cells contain hyaline cytoplasm and show aciniform, papillary and micro-papillary structures (HE 10 & 20).