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Quick Case

RCC With Vena Cava Thrombosis

FIGURE 1A–B. Coronary computed tomography angiogram on initial presentation. (A) Yellow arrow shows right atrial tumor thrombus. Green arrow shows a large, left renal mass. Red arrow depicts left renal venous tumor thrombus. (B) Blue arrows show inferior vena cava tumor thrombus extending into right atrium.

An active, otherwise healthy, 63-year-old man from South Carolina was referred to a urologist after presenting to his primary care physician with anemia, low back pain, and hematuria. Computed tomography (CT) revealed a large renal mass with inferior vena cava (IVC) tumor thrombus and intracardiac tumor thrombus (Figure 1).

Recognizing that few places offer curative treatment for renal cell carcinoma (RCC) with intravascular tumor thrombosis, the urologist referred the patient to Duke Urology.

Question: What treatment could Duke offer the patient, and what was his outcome?

View case conclusion ➧

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