Inferior Vena Cava Syndrome as a Manifestation of Metastatic Carcinoid Tumor

Matthew Stankard; Erik Soule; Jerry Matteo; Matthew Stankard; Erik Soule; Jerry Matteo

doi:10.1159/000514113

Figure 1.

a Axial contrast-enhanced CT image demonstrating diffuse hypoattenuating liver metastases (red arrows). b Coronal contrast-enhanced CT image demonstrating 2 metastases, seen to exert marked mass effect on the IVC (yellow arrows). IVC, inferior vena cava; CT, computed tomography.

Figure 2.

a Axial contrast-enhanced CT image at the level of the heart. Subcutaneous soft tissue above the diaphragm is unremarkable (red arrows). b Axial contrast-enhanced CT image at the level of the sacroiliac joints demonstrating diffuse soft tissue infiltration below the diaphragm (yellow arrows). CT, computed tomography.

Figure 3.

a–c IVC venograms which demonstrate (a) severe external compression (red arrows), (b) stent deployment (blue arrows), and (c) post-stenting and angioplasty with improved patency of the IVC (yellow arrows). IVC, inferior vena cava.

Figure 4.

a, b Axial and coronal contrast-enhanced CT images demonstrating patent stents within a widely patent IVC (red arrows). IVC, inferior vena cava; CT, computed tomography.

Figure 5.

a Axial contrast-enhanced CT images before cryoablation. b Axial intraoperative CT image demonstrating cryoablation probes within the previously noted segment I metastatic lesions (red arrows). c Postcryoablation 2- month follow-up demonstrating reduction in the size of segment I metastatic lesions and patent stent within the IVC. IVC, inferior vena cava; CT, computed tomography.

Figure 6.

a Coronal Ga68 Dotatate PET-CT scan showing maintenance of IVC stent patency at 6-month follow-up (white arrow). b Sagittal Ga68 Dotatate PET-CT scan showing maintenance of IVC stent patency at 6-month follow-up (white arrow). IVC, inferior vena cava; CT, computed tomography.

Figure 7.

a Coronal Ga68 Dotatate PET-CT scan showing maintenance of IVC stent patency at 9-month follow-up (green arrow). b Sagittal Ga68 Dotatate PET-CT scan showing maintenance of IVC stent patency at 9-month follow-up (green arrow). IVC, inferior vena cava; CT, computed tomography.