Abstract
A 52-year-old man without known medical history presented with painful, progressive, bilateral lower extremity edema over a two-week period. An abdominal exam noted a firm left upper quadrant mass. Emergency department (ED) point-of-care ultrasound (POCUS) revealed a hyperechoic, heterogeneous structure in the inferior vena cava that was determined to represent a tumor thrombus extending from a primary renal cell carcinoma. This case demonstrates how POCUS was valuable in rapidly diagnosing this rare cause of lower extremity edema and its usefulness in directing the initial ED management of this patient.
Highlights
Emergency department (ED) point-of-care ultrasound (POCUS) revealed a hyperechoic, heterogeneous structure in the inferior vena cava that was determined to represent a tumor thrombus extending from a primary renal cell carcinoma
ED POCUS revealed a hyperechoic, heterogeneous structure in the inferior vena cava (IVC) representing a tumor thrombus, which often results after intravascular extension of a primary tumor
The patient was diagnosed with high-grade clear cell renal cell carcinoma (RCC) with tumor thrombus extension into the IVC likely resulting in his bilateral leg swelling
Summary
A 52-year-old man without known medical history presented with painful, progressive, bilateral lower extremity edema over a two-week period. Emergency department (ED) point-of-care ultrasound (POCUS) revealed a hyperechoic, heterogeneous structure in the inferior vena cava that was determined to represent a tumor thrombus extending from a primary renal cell carcinoma. This case demonstrates how POCUS was valuable in rapidly diagnosing this rare cause of lower extremity edema and its usefulness in directing the initial ED management of this patient. CASE PRESENTATION A 52-year-old man with no medical history presented to the emergency department (ED) with painful, progressive, bilateral lower extremity edema over a two-week period. Point-of-care ultrasound of the abdomen demonstrating a hyperechoic, heterogeneous structure in the inferior vena cava
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