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. 2019 Oct 14;3(4):451-452.
doi: 10.5811/cpcem.2019.9.43698. eCollection 2019 Nov.

Man With Bilateral Leg Swelling

Jake Toy  1 , Alexander Garrett  1 , Yiju Teresa Liu  1
Affiliations

Man With Bilateral Leg Swelling

Jake Toy et al. Clin Pract Cases Emerg Med. .

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.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Point-of-care ultrasound of the abdomen demonstrating a hyperechoic, heterogeneous structure in the inferior vena cava.
Image 2
Image 2
Computed tomography abdomen and pelvis shown in the coronal (left) and axial (right) view demonstrating a large heterogeneous structure measuring approximately 20 × 14 × 19 centimeters and extending into the inferior vena cava.
See this image and copyright information in PMC

References

    1. Quencer KB, Friedman T, Sheth R, et al. Tumor thrombus: incidence, imaging, prognosis and treatment. Cardiovasc Diagn Ther. 2017;7(Suppl 3):S165–77. - PMC - PubMed
    1. Pussell SJ, Cosgrove DO. Ultrasound features of tumour thrombus in the IVC in retroperitoneal tumours. Br J Radiol. 1981;54(646):866–9. - PubMed
    1. Yanuck J, Ghanem G, Lahham S. Detection of inferior vena cava thrombosis extending into the right atrium using point-of-care ultrasound. Clin Pract Cases Emerg Med. 2019;3(1):67–8. - PMC - PubMed
    1. Lahham S, Tsai L, Wilson SP, et al. Thrombosis of inferior vena cava diagnosed using point-of-care ultrasound after pediatric near-syncope. J Emerg Med. 2016;51(4):e89–91. - PubMed