Imaging Med. (2018) 10() 17 ISSN 1755-5191 A 69 y old man with a past medical history of transglotic carcinoma was admitted to our institution with severe health status deterioration. e laboratory evaluation revealed a suppressed parathyroid hormone (PTH) level and hypercalcemia. He underwent a PET/ CT 18F-FDG scan to investigate a potential malignancy, which showed a linear tracer uptake along the upper half of the inferior vena cava (crosshair), suspicious for tumor thrombus. A Computed tomography angiography was performed and conﬁrmed tumor thrombus in the inferior vena cava and revealed a right- sided kidney mass, compatible with renal cell carcinoma. Intravascular tumor thrombus, deﬁned as tumor extension into a vessel, is a rare complication of solid tumors [1,2]. Propagation of renal cell carcinoma into the inferior vena cava (IVC) has been reported in 4%-10% of patients [3,4]. is case illustrates the usefulness of PET/ CT 18F-FDG in identifying tumor thrombus and its contribution for an accurate staging (FIGURE 1). 18F-FDG uptake in inferior vena cava tumor thrombus KEYWORDS: PET/CT, 18F-FDG, tumor thrombus, inferior vena cava, renal cell carcinoma Patricia Barros Gouveia Ricardo Teixeira 1 , Liliana Violante 2 , Hugo Duarte 2 1 * Portugal Figure 1. PET/CT 18F-FDG images in axial (a), coronal (b) and sagital (c) planes. 18F-FDG uptake along the tumor thrombus in the upper half of the inferior vena cava (crosshair). CLINICAL IMAGE [email protected] *Author for correspondence 1 Centro Hospital e Universitário do Porto, Portugal 2 Instituto Português de Oncologia do Porto Francisco Gentil, Portugal 6

18F-FDG uptake in inferior vena cava tumor thrombus · cava (crosshair), suspicious for tumor thrombus. A Computed tomography angiography was performed and confirmed tumor thrombus

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Page 1: 18F-FDG uptake in inferior vena cava tumor thrombus · cava (crosshair), suspicious for tumor thrombus. A Computed tomography angiography was performed and confirmed tumor thrombus

Imaging Med. (2018) 10(6) 17ISSN 1755-5191

A 69 y old man with a past medical history of transglotic carcinoma was admitted to our institution with severe health status deterioration. The laboratory evaluation revealed a suppressed parathyroid hormone (PTH) level and hypercalcemia. He underwent a PET/CT 18F-FDG scan to investigate a potential malignancy, which showed a linear tracer uptake along the upper half of the inferior vena cava (crosshair), suspicious for tumor thrombus. A Computed tomography angiography was performed and confirmed tumor thrombus

in the inferior vena cava and revealed a right-sided kidney mass, compatible with renal cell carcinoma.

Intravascular tumor thrombus, defined as tumor extension into a vessel, is a rare complication of solid tumors [1,2]. Propagation of renal cell carcinoma into the inferior vena cava (IVC) has been reported in 4%-10% of patients [3,4]. This case illustrates the usefulness of PET/CT 18F-FDG in identifying tumor thrombus and its contribution for an accurate staging (FIGURE 1).

18F-FDG uptake in inferior vena cava tumor thrombus

KEYWORDS: PET/CT, 18F-FDG, tumor thrombus, inferior vena cava, renal cell carcinomaPatricia Barros Gouveia

Ricardo Teixeira1, Liliana Violante2, Hugo Duarte2

Rua Maria Feliciana, N47 r/c direito, 4465-280, Sao Mamede Infesta, Porto, Portugal

Figure 1. PET/CT 18F-FDG images in axial (a), coronal (b) and sagital (c) planes. 18F-FDG uptake along the tumor thrombus in the upper half of the inferior vena cava (crosshair).

CLINICAL IMAGE

[email protected]*Author for correspondence

1Centro Hospital e Universitário do Porto,Portugal

2Instituto Português de Oncologia do Porto Francisco Gentil, Portugal

Page 2: 18F-FDG uptake in inferior vena cava tumor thrombus · cava (crosshair), suspicious for tumor thrombus. A Computed tomography angiography was performed and confirmed tumor thrombus

REFERENCES1. Quencer KB, Friedman T, Sheth R et al.

Tumor thrombus: incidence, imaging, prognosis and treatment. Cardiovasc. Diagn. Ther. 7: 165-177, (2017).

2. Lai P, Bomanji JB, Mahmood S et al. Detection of tumour thrombus by 18F-FDG-PET/CT imaging. Eur. J. Cancer. Prev. 16: 90-94, (2007).

3. Giuliani L, Giberti C, Martorana G et al. Radical extensive surgery for renal cell

carcinoma: long-term results and prognostic factors. J. Urol. 143: 468-473, (1990).

4. Jungberg B, Stenling R, Osterdahl B et al. Vein invasion in renal cell carcinoma: impact on metastatic behavior and survival. J. Urol. 154: 1681-1684, (1995).

Imaging Med. (2018) 10( )18

CLINICAL IMAGE Gouveia