From the case: Hypercalcemia of malignancy
Axial C+ arterial phase
11 cm irregular exophytic right upper pole renal mass noted. Abnormal soft tissue is seen in the right suprarenal region and the right adrenal gland cannot be clearly identified (it is thought to be infiltrated.) The renal tumour has perinephric extension and there are abnormal filling defects seen within the IVC compatible with tumour thrombus.