Left renal vein thrombus associated with renal tumor
Citation, DOI & case data
Previously known malignant left renal tumor, classified as renal cell carcinoma by histopathology. Weight loss, lethargy and malaise. In the pre-surgical protocol, a study is requested to rule out extension to the left renal vein.
Loading Stack -
0 images remaining
Axial T2-weighted projection shows a left renal tumor with heterogeneous enhancement in the upper pole, dilated ipsilateral renal vein with absence of flow void in its most proximal portion.
DWI and ADC projections show partial diffusion restriction of the left renal tumor. Renal vein shows no obvious diffusion restriction.
Axial T1-weighted projection with intravenous contrast in late phase shows heterogeneous enhancement of a tumor in the left renal upper pole with a filling defect in ipsilateral renal vein without enhancement.
A tumor thrombus is defined as a tumor extending into a vessel. Imaging features include the presence of enhancement similar to a tumor of origin, vessel expansion, and diffusion restriction.
On the other hand, bland thrombus generally shows no restricted diffusion or enhancement and its behavior is independent of tumor activity.
In this case, a filling defect is identified in the ipsilateral renal vein without enhancement or restriction to diffusion, which is suggestive of a soft thrombus.
- 1. Catalano OA, Choy G, Zhu A, Hahn PF, Sahani DV. Differentiation of malignant thrombus from soft thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion-weighted MR imaging. (2010) Radiology. 254
- 2. Li M, Shi A, Kong W et al. Transitional cell carcinoma with renal vein extension and IVC tumor thrombus: report of three cases and review of the literature. World Surgery Oncology J. 2016;14(1):309.