Inferior Vena Cava / RCC Tumor Thrombus
Clinical History
75-year-old female diagnosed with renal cell carcinoma of the right kidney. The CT morphology did not allow sufficiently precise evaluation of a possible involvement of the inferior vena cava .
MR Imaging
MR imaging was performed using a GE CVi MR scanner (1.5 T). For further details please click the link below.
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Fig. 1. Intrahepatic cranial boundary of the intracaval tumor thrombus (arrow).
Fig. 2. Caudally, the vascularized tumor thrombus can be clearly distinguished from the attached non-vascularized appositional thrombus (arrow).
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Fig. 3. Extension of the thrombus into the contralateral left renal vein can be seen (arrow).
Fig. 4. Good differentiation between vascularized thrombus and nonvascularized appositional thrombus (arrows).
Comments
Steady-state imaging was performed after gadofosveset administration. The renal cell carcinoma can be identified as a highly vascularized mass at the upper pole of the right kidney. Invasion of the inferior vena cava can be seen. Intrahepatically, the cranial boundary between the intracaval tumor thrombus and the uninvolved, well enhanced vascular lumen is clearly defined. Caudally, the vascularized tumor thrombus can be clearly distinguished from the attached non-vascularized appositional thrombus.
Diagnosis
Right-sided renal cell carcinoma with extensive tumor thrombus into the inferior vena cava. The tumor thrombus extends into the intrahepatic part of the inferior vena cava. Appositional thrombus in the left renal vein and extending caudally.
Authors
J. Lotz, MD, and A. Vafa, MD, Diagnostic Radiology, MHH Hannover, Germany.