Massive inferior vena caval thrombosis

Case contributed by Dr Ian Bickle

Presentation

Known metastatic prostate carcinoma. Sudden onset shortness of breath.

Patient Data

Age: 70
Gender: Male

Following an incidence of shortness of breath a echocardiogram was performed to assess cardiac function. Concern over a possible pulmonary embolus was raised. CTPA performed - bilateral main pulmonary emboli identified. Inferior slices of CTPA raised concern with radiologist - proceeded to CT abdomen.

Massive IVC thrombosis - almost forming a 'cast' of the IVC.  

Extends into the right atrium.

Sclerotic bony metastases from primary prostate tumour.

Liver lesion with previous chemoembolisation.

The mint from which the name arises - the hole presenting the thrombus. The mint itself the intra-luminal contrast rim.

Case Discussion

This case demonstrates a gigantic IVC thrombosis extending from the right atrium to below the renal veins, over a length of 15cm.

Known underlying prostatic malignancy likely to have caused the pro-thrombotic state of the patient.

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Case information

rID: 23860
Case created: 14th Jul 2013
Last edited: 26th Feb 2016
Inclusion in quiz mode: Included

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