CT - Subsequent CT abdomen/pelvis
There is a large, lobulated, heterogeneous and minimally calcified retroperitoneal soft tissue mass centred on the infrarenal inferior vena cava. Much of the infrarenal inferior vena cava is imperceptible; tumour thrombus is seen extending cranially through the lumen of the inferior vena cava up to the level of the liver. The renal veins and right atrium are spared.
Marked pelvic venous congestion, presumably consequent on impaired drainage into the iliocaval system.
Numerous hypoattenuating liver masses and basal pulmonary nodules in keeping with metastases.
Partially captured soft tissue nodule within the anterior musculature of the right thigh; intraperitoneal soft tissue nodule within the left iliac fossa, deep to the transversus aponeurosis; subcutaneous soft tissue mass overlying the left-sided lumbar paraspinal musculature; all in keeping with metastases.
Sclerotic lesions within inferior right scapula, within the T12 vertebral body, and within the left ilium in keeping with osseous metastases.