Presentation
Hematuria.
Patient Data
Huge left-sided renal mass with bulk dimensions of 16 x 11 cm occupying all of the very upper pole of the left kidney. Extensive tumor extension into the left renal vein, infra and supradiaphragmatic IVC with tumor thrombus in the right atrium.
The tumor extends into the right paravertebral vein at the level of L2.
Indistinct soft tissue in the left para-aortic space likely conglomerate lymph node.
Simple cysts in the liver. No adrenal nodules.No sinister bone lesion.
Hysterectomy. Sigmoid diverticulosis. Hiatus hernia.
Case Discussion
A mind blowing case of venous tumor extension from a massive left-sided renal cell carcinoma with tumor thrombus into the IVC.
The tumor has extended from the contralateral side of the abdomen into the long left renal vein into and massively expanding the IVC and is dangling in the right atrium, causing a risk of tumor embolus. The collective volume of tumor within the venous system is large.
This is the first time I have seen tumor extend into a paravertebral vein too from a renal cell carcinoma.
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