Ultrasound features of tumour thrombus in the IVC in retroperitoneal tumours

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Abstract
Tumor invasion of the inferior vena cava (IVC) is a complication of retroperitoneal tumors that can be identified at the time of ultrasound B scanning. Nine patients with proven IVC tumor thrombus were recognized from such tumors, and several common ultrasound features were noted. Six of these cases were associated with renal carcinoma, 2 with metastatic teratoma and 1 with rhabdomyosarcoma. The typical appearance included abnormal echogenic solid material in the lumen of the vessel. In sagittal section the anterior wall was domed as it stretched over the thrombus; and on real time scanning, there was loss of the normal venous pulsations. Although similar abnormalities occur with non-tumor thrombus, the presence of these typical features in association with a retroperitoneal tumor is likely to represent tumor invasion of the IVC, an important observation for accurate staging and subsequent management.