Azygos venous tumor thrombus from renal cell carcinoma detected by F-18 FDG PET/CT.

Abstract

An 81-year-old woman with renal cell carcinoma (RCC) underwent F-18 FDG PET/CT for staging, which demonstrated intense uptake in a dilated azygos vein, in the inferior vena cava (IVC), and in the known large left RCC. Contrast-enhanced CT of the chest and abdomen obtained in the days following confirmed the presence of tumor thrombus in the dilated azygos system, IVC, and the contiguous left renal vein. This case serves as a reminder that special attention should always be paid to the renal vein, IVC, and adjoining venous drainage pathways for abnormal FDG activity while imaging RCC, as the diagnosis of venous tumor thrombus has important clinical ramifications.