A low T2 signal intensity is a well-known feature of fat-poor angiomyolipoma and papillary renal cell carcinoma. However, many other renal tumors showing low T2 signal intensity are encountered in daily practice. So, a low T2 signal intensity is not a pathognomonic finding for fat-poor angiomyolipoma and papillary RCC. Even though renal mass biopsy might be considered to establish a diagnosis for tumors without typical imaging features of renal cell carcinoma, the decision to biopsy or not sometimes seems to be difficult in small renal tumors. Accurate MR imaging characterization of renal masses is essential for ensuring appropriate management and avoiding unnecessary surgical procedure.
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