Renal Cell Carcinoma with Thrombus Extension into the Inferior Vena Cava and the Right Atrium: A Case Report

Figures

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  Figure 1. Axial cut of a computed tomographic scan of the abdomen showing large heterogeneous mass (arrows) in the mid to lower aspect of the right kidney concerning for RCC. A filling defect extending from the renal hilum through the right renal vein and into the IVC (green arrow) is also noted.

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  Figure 2. An axial cut of a computed tomographic scan of the chest showing large thrombus in the distal right main pulmonary artery (arrow).

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  Figure 3. Sagittal view of the abdomen showing propagation of the previously noted IVC tumor thrombus up to the right atrium (arrows).

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  Figure 4. Coronal view of the abdomen showing propagation of the previously noted IVC tumor thrombus up to the right atrium (arrows).

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  Figure 5. Transesophageal echocardiographic view of the IVC and hepatic vein (HV) shows tumor/thrombus (arrows) involvement of the IVC.

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  Figure 6. Transesophageal echocardiographic transgastric four-chamber view, focused on the right atrium (RA), showing mass prolapsing (arrows) from the IVC into the RA.

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  Figure 7. Pulsed-wave Doppler of the hepatic vein showing normal Doppler flow.

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  Figure 8. Transesophageal echocardiographic bicaval view with deeper insertion shows the hepatic vein (HV) clear of tumor thrombus. A distinction of echogenicity can be made between the more echogenic proximal end and the less echogenic distal (atrial) end of the mass, with the latter representing bland thrombus (encircled).