Medical image of the month: renal cell carcinoma with extensive tumor thrombus

• Main Authors: Horn D, Cassidy S, Snyder L
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2019-09-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: renal cell carcinoma; metastasis; CT scan; inferior vena cava; right atrium; treatment; prognosis; staging; perioperative risk; survival
• Online Access: http://www.swjpcc.com/imaging/2019/9/2/medical-image-of-the-month-renal-cell-carcinoma-with-extensi.html

No abstract available. Article truncated after 150 words. A 53-year-old man with a right-sided renal cell carcinoma (RCC) presented with nausea, vomiting, intolerance of oral intake and melena. A contrast enhanced CT of the abdomen and pelvis showed near complete replacement of the right kidney by a large heterogeneous mass, measuring 10 x 16 cm (Figure 1). The mass invaded the renal vein and inferior vena cava (IVC) with extension to the level of the inferior cavo-atrial junction (Figure 2). The mass compressed the duodenum, causing a bowel obstruction. Liver and lung metastases were also found. A duodenal stent was placed with significant improvement in his nausea and vomiting. He was not able to receive anticoagulation due to severe gastrointestinal bleeding. The patient discontinued disease modifying therapy and died four weeks after discharge from the hospital. Tumor thrombus occurs when a tumor invades a blood vessel. It occurs in approximately 10% of patients with renal cell carcinoma, which …