Intraluminal Tumour Thrombus of a Mixed Non-Seminomatous Germ Cell Tumour of Testis within the Inferior Vena Cava

Badawi, Jasmin Katrin; Kittner, Thomas; Manseck, Andreas; Wirth, M.

doi:10.1159/000082731

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…Since the inferior vena cava thrombus lengths of earlier cases had been generally short, these patients were treated with either chemotherapy alone or surgery excision of thrombus after the chemotherapy (4–7). Only one case was reported with inferior vena cava thrombus extended from the infrarenal level to the common iliac veins (8).…”

Section: Discussionmentioning

confidence: 99%

Pure Yolk sac presenting with inferior vena cava thrombus extending from bilateral external iliac veins to hepatic vein

2016

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Introduction:Vena cava thrombus is an extremely rare complication of testicular tumors. We report on an unusual case of testicular tumor presenting with inferior vena cava thrombus extending from the left spermatic and bilateral external iliac veins to the hepatic vein.Case report:A-35-year old man presented with a 6-month history of left scrotal mass and a 1-day history of bilateral lower extremity edema. Computed tomography (CT) revealed the presence of thrombus extending from the left spermatic vein and bilateral external iliac veins to the hepatic vein, and multiple lymph node and lung metastases. 3 cycles of chemotherapy were given after the left high inguinal orchiectomy. Pathological examination demonstrated a pure yolk sac carcinoma with lymphovascular invasion and direct tumor extension into the left spermatic cord. CT and positron emission tompgraphy-CT obtained no findings of metastasis or recurrence at 3 months after the chemotherapy.Conclusion:We review this seldom case and discuss the literature with regard to its diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Pure Yolk sac presenting with inferior vena cava thrombus extending from bilateral external iliac veins to hepatic vein

2016

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“…A tumour thrombus will be FDG avid on PET CT as it is metabolically active due to trace uptake. A bland thrombus will be non-FDG avid on PET CT. On diffusion weighted MRI, the thrombus will show restricted diffusion with low ADC values [3], [18]. F FDG PET CT scan can differentiate between hyper-metabolic tumoral thrombosis and non-hyper-metabolic bland thrombosis on IVC.…”

Section: Ivc Thrombosis In Testicular Tumour Occurs By 2 Mechanisms [4]mentioning

confidence: 99%

Nonseminomatous Germ Cell Testicular Tumour With Metastatic Retroperitoneal Lymphadenopathy Presenting As Severe Backache Due To Ivc Thrombosis

Khaladkar

Sekhon

Agrawal

et al. 2020

EJMED

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IVC thrombosis is often under-recognized. Malignancy can cause spontaneous IVC thrombosis due to its prothrombotic potential. Malignant tumors can compress, adhere or infiltrate the IVC wall causing endothelial damage with subsequent thrombosis. Retroperitoneal lymphadenopathy can cause compressive distortion of IVC causing venous stasis and turbulent flow. Metastatic retroperitoneal lymphadenopathy from testicular tumor is a rare cause of IVC invasion with resultant IVC thrombosis which can rarely present as backache. High index of suspicion is needed to detect primary testicular tumor in cases of IVC thrombosis, especially in young individuals. A 26 -year old male presented with lower back ache, weight loss and fever. MRI Lumbosacral spine done outside showed a soft tissue signal intensity retroperitoneal mass in aortocaval region compressing IVC. Ultrasound (done outside) revealed mild right sided hydroureteronephrosis secondary to a lobulated heterogeneous mass in inter-aortocaval region encasing right ureter and invading IVC causing thrombosis. Contrast enhanced Computerized axial tomography of abdomen showed a heterogeneously enhancing lobulated mass with multiple internal calcifications, in inter-aortocaval region at L3-4 level invading the IVC causing IVC thrombosis. Both tumor thrombus and bland thrombus were present. The right testis showed a subtle 10x10 mm hypodense lesion with peripheral calcification. DW-MRI showed diffusion restriction in retroperitoneal mass and the IVC tumor thrombus. Possibility of primary testicular tumor with metastatic retroperitoneal lymphadenopathy causing IVC invasion with resultant thrombosis was considered which was confirmed on histopathology examination.

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“…PET/CT has a potential for differentiation of tumoral and bland thrombus. Diagnosis of tumoral thrombosis is also important to prevent undesired anticoagulation 1,6–8 . In our case, anticoagulant treatment was added to etoposide and cisplatin regimen by the medical oncology department after the involvement of the venous system.…”

mentioning

confidence: 92%

“…There are 2 cases of azygos vein tumor thrombosis related to renal cell carcinoma reported in the literature 5,7 . Although rare, the diagnosis of tumor thrombi is vital in oncologic patients 2,8 . PET/CT has a potential for differentiation of tumoral and bland thrombus.…”

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confidence: 99%

Uncommon Testicular Germ Cell Tumor Thrombus in Azygos Vein Detected by FDG PET/CT

Peker

Toprak²,

Yasin³

et al. 2021

Clin Nucl Med

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A 40-year old man admitted to the nuclear medicine department to undergo PET/CT for restaging of known testicular germ cell tumor. The patient had a history of orchiectomy for left testis and left nephrectomy with retroperitoneal lymph node dissection. Histopathology revealed testicular germ cell tumor. During the follow-up period, there is a rapidly expanding mass in posterior mediastinum. PET reveals increased FDG activity in the azygos vein. Contrast-enhanced CT of the thorax showed distended azygos vein with heterogeneously enhancing thrombus and peripheral fat stranding. Findings are consistent with azygos vein tumor thrombosis related to testicular germ cell tumor.

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Intraluminal Tumour Thrombus of a Mixed Non-Seminomatous Germ Cell Tumour of Testis within the Inferior Vena Cava

Cited by 5 publications

References 10 publications

Pure Yolk sac presenting with inferior vena cava thrombus extending from bilateral external iliac veins to hepatic vein

Pure Yolk sac presenting with inferior vena cava thrombus extending from bilateral external iliac veins to hepatic vein

Nonseminomatous Germ Cell Testicular Tumour With Metastatic Retroperitoneal Lymphadenopathy Presenting As Severe Backache Due To Ivc Thrombosis

Uncommon Testicular Germ Cell Tumor Thrombus in Azygos Vein Detected by FDG PET/CT

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