Abstract
The purpose of this study was to examine the distribution of venous thrombi associated with primary or secondary abdominal malignancies on magnetic resonance (MR) imaging with respect to thrombus type (bland vs. tumor), tumor sites, tumor types, and veins involved in a large oncologic patient population. In a retrospective review of 10,908 oncologic patients, MR imaging studies identified 142 (1.3%) showing venous thrombi, of which 55 (0.5%) were bland and 87 (0.79%) were tumor thrombus. Bland thrombi were most commonly seen in liver (35%; 19/55) and retroperitoneal malignancies (24%; 13/55) and were most often located in the inferior vena cava (45%; 25/55) and the portal vein (22%; 12/55). Tumor thrombi were most commonly seen in renal (55%; 48/87) and liver (32%; 28/87) malignancies. The prevalence of tumor thrombi was 8.8% (48/545) in primary renal, 4.7% (6/126) in primary retroperitoneal, 2.9% (19/634) in primary liver, and 1.8% (9/479) in secondary liver malignancies. Tumor thrombi were most commonly located in the inferior vena cava (57%; 50/87), the renal vein (48%; 42/87), and the portal vein (29%; 25/87).
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Kaufman LB, Yeh BM, Breiman RS, et al. (2005) Inferior vena cava filling defects on CT and MRI. AJR Am J Roentgenol 185:717–726
Tublin ME, Dodd GD 3rd, Baron RL (1997) Benign and malignant portal vein thrombosis: differentiation by CT characteristics. AJR Am J Roentgenol 168:719–723
Aslam Sohaib SA, Teh J, Nargund VH, et al. (2002) Assessment of tumor invasion of the vena caval wall in renal cell carcinoma cases by magnetic resonance imaging. J Urol 167:1271–1275
Ergen FB, Hussain HK, Caoili EM, et al. (2004) MRI for preoperative staging of renal cell carcinoma using the 1997 TNM classification: comparison with surgical and pathologic staging. AJR Am J Roentgenol 182:217–225
Hatcher PA, Anderson EE, Paulson DF, Carson CC, Robertson JE (1991) Surgical management and prognosis of renal cell carcinoma invading the vena cava. J Urol 145:20–23
Skinner DG, Pritchett TR, Lieskovsky G, Boyd SD, Stiles QR (1989) Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-term survival. Ann Surg 210:387–392
Neves RJ, Zincke H (1987) Surgical treatment of renal cancer with vena cava extension. Br J Urol 59:390–395
O’Donohoe MK, Flanagan F, Fitzpatrick JM, Smith JM (1987) Surgical approach to inferior vena caval extension of renal carcinoma. Br J Urol 60:492–496
Tsuji Y, Goto A, Hara I, et al. (2001) Renal cell carcinoma with extension of tumor thrombus into the vena cava: surgical strategy and prognosis. J Vasc Surg 33:789–796
Johnson CD, Dunnick NR, Cohan RH, Illescas FF (1987) Renal adenocarcinoma: CT staging of 100 tumors. AJR Am J Roentgenol 148:59–63
Horan JJ, Robertson CN, Choyke PL, et al. (1989) The detection of renal carcinoma extension into the renal vein and inferior vena cava: a prospective comparison of venacavography and magnetic resonance imaging. J Urol 142:943–948
Myneni L, Hricak H, Carroll PR (1991) Magnetic resonance imaging of RCC with extension into the vena cava: staging accuracy and recent advances. Br J Urol 68:571–578
Kallman DA, King BF, Hattery RR, et al. (1992) Renal vein and inferior vena cava tumor thrombus in renal cell carcinoma: CT, US, MRI and venacavography. J Comput Assist Tomogr 16:240–247
Roubidoux MA, Dunnick NR, Sostman HD, Leder RA (1992) Renal cell carcinoma: detection of venous extension with gradient-echo MR imaging. Radiology 182:269–272
Welch TJ, LeRoy AJ (1997) Helical and electron beam CT scanning in the evaluation of renal vein involvement in patients with renal cell carcinoma. J Comput Assist Tomogr 21:467–471
Laissy JP, Menegazzo D, Debray MP, et al. (2000) Renal carcinoma: diagnosis of venous invasion with Gd-enhanced MR venography. Eur Radiol 10:1138–1143
Connolly GC, Chen R, Hyrien O, et al. (2008) Incidence, risk factors and consequences of portal vein and systemic thromboses in hepatocellular carcinoma. Thromb Res 122:299–306
Jonas S, Bechstein WO, Steinmüller T, et al. (2001) Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology 33:1080–1086
Takizawa D, Kakizaki S, Sohara N, et al. (2007) Hepatocellular carcinoma with portal vein tumor thrombosis: clinical characteristics, prognosis, and patient survival analysis. Dig Dis Sci 52:3290–3295
Minagawa M, Makuuchi M (2006) Treatment of hepatocellular carcinoma accompanied by portal vein tumor thrombus. World J Gastroenterol 12:7561–7567
Heaston DK, Chuang VP, Wallace S, de Santos LA (1981) Metastatic hepatic neoplasms: angiographic features of portal vein involvement. AJR Am J Roentgenol 136:897–900
Lee KF, Chu W, Lai PB (2005) Portal vein tumor thrombus in colorectal liver metastasis. Am J Surg 190:364–365
Hoehn W, Hermanek P (1983) Invasion of veins in renal cell carcinoma—frequency, correlation, and prognosis. Eur Urol 9:276–280
Nesbitt JC, Soltero ER, Dinney CPN, et al. (1997) Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus. Ann Thorac Surg 63:1592–1600
Pagano F, Dal Bianco M, Artibani W, et al. (1992) Renal cell carcinoma with extension into the inferior vena cava: problems in diagnosis, staging, and treatment. Eur Urol 22:200–203
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An erratum to this article can be found at http://dx.doi.org/10.1007/s00261-010-9614-8
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Engelbrecht, M., Akin, O., Dixit, D. et al. Bland and tumor thrombi in abdominal malignancies: magnetic resonance imaging assessment in a large oncologic patient population. Abdom Imaging 36, 62–68 (2011). https://doi.org/10.1007/s00261-010-9608-6
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DOI: https://doi.org/10.1007/s00261-010-9608-6