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Although renal hypernephroma is of relatively frequent occurrence and metastasis by way of the venous system the usual mode of dissemination of the tumor tissue, it is rare to find extensive growth into the inferior vena cava and rarer still to have an intravascular hypernephroma occlude this vessel in its entire length and extend into the right chambers of the heart. In the present instance we have the unique picture of occlusion of the entire inferior vena cava from a hypernephroma growing along the left renal vein, completely filling the inferior vena cava from the iliac bifurcation to the right auricle, with the tumor mass extending through the tricuspid orifice into the right ventricle. The hepatic veins were thrombosed. There was acute central necrosis of the liver and death in acidosis. REPORT OF CASEHistory. —The patient, a man aged 63, entered the medical service of the Peter Bent Brigham
Victor C. Jacobson (1918) studied this question.