CT - CT at presentation.
Hypoenhancing, partially exophytic mass arising from the superior right moiety of the horseshoe kidney with tumor thrombus extending into the right renal vein, proximal portion of the left renal vein, and inferior vena cava (IVC). Bland thrombus in the infrarenal IVC extending into the common iliac veins.
Bilateral adrenal nodules concerning for metastases.
Minimal intraperitoneal effusion is noted.
Partially visualized pulmonary emboli are seen in the lung bases.