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This patient has a renal cell carcinoma (RCC) of the left kidney invading the renal vein. RCC has a strong propensity to venous invasion which is seen up to 20% of cases, with extension into the IVC in 4 to 15% of cases. Renal vein invasion classifies RCC as TNM stage T3 and Robson stage 3A. Tumour thrombus is distinguished from bland thrombus by contrast enhancement on CT and MRI and colour flow on ultrasound. Other tumours with a strong tendency to venous invasion are hepatocellular carcinoma and adrenal carcinoma.
References:
1. Kaufman J & Lee M. Vascular & Interventional Radiology: The Requisites, Mosby 2004
2. Renal cell carcinoma staging, Radiopaedia.org
Credit: Dr Donna D'Souza
http://www.radpod.org

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