An incidental mass in the inferior vena cava discovered on echocardiogram

Introduction: The differential diagnosis of an inferior vena cava (IVC) mass in an asymptomatic patient is broad and includes both thrombus and neoplastic etiologies. Once identified, new IVC masses should be further evaluated for possible malignancy. Up to 10% patients with renal cell carcinoma have direct extension of the tumor into the IVC, with 1% extending to the level of the right atrium. Case Report: A 73­year­old woman was referred for an elective two­dimensional echocardiogram after her cardiologist noted a new murmur. The patient was asymptomatic at that time. The echocardiogram revealed a mass in the IVC, two centimeters from the right atrium. Further work up revealed a large renal cell carcinoma. Conclusion: All imaging results should be carefully reviewed for incidental evidence of previously undiagnosed disease. Malignant renal cell carcinoma is often first identified as an incidental mass on abdominal CT scan or ultrasound scan, It is exceedingly rare for a malignant renal cell carcinoma to initially present as an incidental mass on echocardiogram.