Abstract
A 79-year-old man with a medical history of metastatic colon cancer to the liver and lung presented to the emergency department with shortness of breath. Computed tomographic (CT) angiography of the chest demonstrated an endovascular mass extending from the intrahepatic inferior vena cava into the right atrium (Fig 1, arrow). Suction thrombectomy was initially considered, but it was unclear whether the mass represented bland or tumor thrombus. IVC angiography confirmed a lobulated mass within the intrahepatic IVC extending into the right atrium (Fig 2, arrow). Transvenous core biopsy specimens were obtained during the procedure (Fig 3). Pathologic examination revealed clusters of columnar cells with cytomorphologic features of glandular malignancy (Fig 4a) and strong nuclear staining with CDX2, confirming the cell origin from the patient’s colon cancer primary malignancy (Fig 4b). The patient tolerated the procedure well and was discharged home to follow up with his oncologist.Figure 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 4View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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