Presentation
Known metastatic prostate carcinoma. Sudden onset shortness of breath.
Patient Data
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 tumor.
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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