Clinics in diagnostic imaging (44). Testicular tumour with retroperitoneal lymphadenopathy and inferior vena cava thrombosis.
A 20-year-old Indian man presented with a two week history of non-specific abdominal pain. Abdominal ultrasonograpy incidentally detected a thrombus in the inferior vena cava (IVC). Computed tomography revealed the presence of extensive para-aortic lymph node disease as well as a filling defect in the IVC. Scrotal ultrasonography located a heterogeneous intra-testicular tumour in an otherwise palpably-normal testis. The extent of the IVC thrombus was evaluated by the use of magnetic resonance imaging. Inguinal orchidectomy was performed and histology revealed a non-seminomatous germ cell tumour. Combination chemotherapy led to complete resolution of lymph node disease and IVC thrombus. The patient remained well 9 months after diagnosis. The causes of IVC obstruction, role of imaging in investigating IVC obstruction and the management of tumour involvement of the IVC are discussed.
Choy
D K
DK
Department of Urology, Singapore General Hospital, Singapore.
Yip
S K
SK
Cheng
W S
WS
Tan
B S
BS
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D010146:Pain / Q000209:etiology; D011859:Radiography; D012187:Retroperitoneal Space / Q000473:pathology; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000473:pathology*; D020246:Venous Thrombosis / Q000209:etiology / Q000473:pathology*
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin