Renal cell carcinoma presenting as pulmonary embolism

Shaikh Saud Abdul Jaish, Prashant Kashyap, Santwana Chandrekar, Varun Shetty


We report a case of massive pulmonary embolus demonstrated on CT in an adult male presenting with dyspnea, with no known risk factors for embolism. Abdominal CT on further investigation showed a renal tumor invading the left renal vein and the inferior vena cava as the cause of the pulmonary embolus. In a patient presenting with pulmonary artery embolism without venous thrombosis, the differential diagnosis should include an occult tumor as the cause of the embolus.


Computed tomography, Pulmonary embolus, Renal cell carcinoma

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Bhayani SB, Liapis H, Kibel AS. Adult clear cell sarcoma of the kidney with atrial tumor thrombus. J Urol. 2001;165:896-7.

Chen PC, Chang YH, Yen CC, et al. Primary renal synovial sarcoma with inferior vena cava and right atrium invasion. Int J Urol. 2003;10:657-60.

Karnes RJ, Gettman MT, Anderson PM, et al. Primitive neuroectodermal tumor (extraskeletal Ewing's sarcoma) of the kidney with vena caval tumor thrombus. J Urol. 2000;164:772.

Ohwada S, Ishikawa S, Kawashima Y, et al. Intraoperative massive pulmonary tumor embolism from clear cell sarcoma in the retroperitoneum successful treatment using cardiopulmonary bypass. Hepatogastroenterology. 2004;51:987-9.

Rosso D, Ghignone GP, Bernardi D, et al. Clear cell sarcoma of the kidney with invasion of the inferior vena cava. Urol Int. 2003;70:251-2.

Takigawa H, Kagawa S, Nakamura S, et al. A case of fibrosarcoma of the kidney extending into the inferior vena cava. Hinyokika Kiyo. 1987; 33:936-9.

Toyoda Y, Yamashita C, Sugimoto T, et al. Clear cell sarcoma of kidney with tumor extension into the right atrium. J Cardiovasc Surg. 1998; 39:489-91.

Chen HT, Chen JT, Hung SW, et al. Primary renal sarcoma with inferior vena cava thrombus presenting with tumor rupture. Zhonghua Yi Xue Za Zhi. 2001;64:183-6.

Grutzner G, Furst G, Kuhn FP, et al. Retroperitoneal myxoid liposarcoma of the kidney capsule as a cause of Budd-Chiari syndrome. Aktuelle Radiol 1991;1:308-11.

Baba K, Yamaguchi O, Nomiya M, et al. A case of adult Wilms' tumor with vena caval involvement. Hinyokika Kiyo. 1995;41:369-72.

Parekh DJ, Cookson MS, Chapman W, et al. Renal cell carcinoma with renal vein and inferior vena caval involvement clinicopathological features, surgical techniques and outcomes. J Urol 2005;173:1897-902.

Shirkhoda A, Lewis E. Renal sarcoma and sarcomatoid renal cell carcinoma CT and angiographic features. Radiology. 1987;162:353-7.