Tumor thrombus in right atrium, IVC and right renal vein: from renal cell carcinoma

Case contributed by Oliver Hennessy
Diagnosis probable


Hematuria in a 71 year old man

Patient Data

Age: 71
Gender: Male

There is a filling defect in the right atrium. This abnormality was noted to extend from the IVC into the atrium.

Further CT imaging of the abdomen revealed a solid right renal mass. Thrombus, most likely tumor thrombus also involved the right renal vein and extended into the IVC.

Case Discussion

Filling defects in an atrial cavity may be due to bland thrombus, tumor thrombus, an atrial myxoma, a metastasis and lymphoma. The commonest primary atrial tumor is a myxoma.

Tumor thrombus can be differentiated from bland thrombus using CT arteriography or FDG PET imaging.

Atrial metastasis is uncommon, the primary site maybe melanoma or a primary renal cancer.

Atrial thrombus resulting from IVC extension is most commonly seen when a renal cancer involves the renal vein and IVC.

Primary leiomyosarcoma of the IVC may also involve the right atrium.

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