Neoplastic thrombosis in the inferior vena cava

Case contributed by Dr Teresa Fontanilla

Presentation

Right flank pain and faintness.

Patient Data

Age: 25 years
Gender: Female

The longitudinal sonographic view demonstrates an intraluminal IVC mass. Power doppler demonstrates incomplete obstruction of the IVC. Further evaluation with contrast-enhanced ultrasound demonstrates vessels within the mass at 46 seconds and enhancement of the mass at 1 minute and 12 seconds.

Longitudinal contrast-enhanced CT image (corticomedullary phase) shows thrombus inside the IVC.

Case Discussion

When a renal mass is found, excluding renal vein and IVC involvement is mandatory and may be performed by means of US, CT and MR. Differentiation between bland or tumor thrombus requires contrast to demonstrate thrombus enhancement. In this case the patient attended our institution with right flank pain due to previously unknown renal tumor with active bleeding, and an emergency US was performed, with CEUS performed on the go to demonstrate thrombus enhancement.

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Case information

rID: 30840
Published: 7th Sep 2014
Last edited: 23rd Oct 2019
Tag: ceus
Inclusion in quiz mode: Included

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