Tumor thrombosis of the inferior vena cava secondary to malignant abdominal neoplasms US, CT and MRI evaluation

ABSTRACT

18 patients with histologically proved tumor thrombi of the inferior vena cava [IVC] secondary to abdominal neoplasms were studied with the use of ultrasonography [US]. The primary neoplasms were renal cell carcinoma [10 cases], adrenal tumors [2 cases], retroperitoneal tumors [2 cases], and hepatic tumors [4 cases]. The positive diagnosis of tumor thrombus was better demonstrated by US studies, which showed echogenic endoluminal material within an enlarged IVC with a bulging anterior wall. On CT scans the tumor thrombus usually appeared as endoluminal filling defect surrounded by a rim of contrast material. Tumor thrombus could be evaluated by MRI appeared as endoluminal low signal intensity filling the IVC and expanding it. Invasion and extension outside the wall was better. US, CT and MRI are complementary in the preoperative assessment of tumor thrombus and their use obviates. The need for venacavography in many cases which is hazardous because of the possibility of dislodging thrombi and failed to demonstrate the cephalad extension of the tumor thrombus