Tumour thrombus

Tumour thrombus is defined as tumour extending into a vessel, typically a vein. It occurs in a wide variety of malignancies. It is vital to distinguish tumour thrombus from "bland" thrombus (free of neoplastic cells) in the setting of neoplasia, as this often impacts staging and treatment approach.

Tumour thrombus is usually composed of a soft tissue component and a thrombotic component.

Tumour thrombus is perhaps most frequently associated with renal cell carcinoma, where tumour may invade the renal vein and grow caudally into the right atrium. However, this phenomenon is not isolated to renal cell carcinoma, and is recognised in 2,3:

Imaging features consistent with tumour thrombus on contrast-enhanced CT and MRI include: 

  • presence of enhancement 3
  • appearance of vessel expansion 3
  • increased activity associated with the thrombus on CT 3

In renal cell carcinoma, it may be possible to remove thrombus retrogradely at nephrectomy but the presence and nature of any tumour thrombus are important for determining the TNM stage.

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Article information

rID: 2227
Synonyms or Alternate Spellings:
  • Tumor thrombus
  • Tumour thrombosis
  • Tumour clot
  • Tumour containing thrombus

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Cases and figures

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    Case 1 : CT of renal cell carcinoma tumour thrombus
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    Case 2: RCC with tumour thrombus into the IVC
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    Case 3: renal cell carcinoma with IVC invasion
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