Bilateral pulmonary artery tumour emboli from renal carcinoma

A 53-year-old male presented with shortness of breath and dyspnoea on exertion, which he noticed for several months. CT of the chest showed bilateral main pulmonary artery emboli with extension into the interlobar and segmental arteries, as well as several pulmonary infarcts figure a). An abdominal CT scan showed a renal mass 9·8×8·6 cm) in the right kidney that xtended into the nferior vena cava cranially to the level of the hepatic vasculature (figure b). A bilateral pulmonary embolectomy followed by a right nephrectomy with caval thrombectomy were done in the same surgical setting. A pathological review showed renal-cell carcinoma in samples of both the kidney and pulmonary artery. The patient's recovery was uneventful and he was discharged from the hospital 8 days later, with plans to receive adjuvant interleukin-2 immunotherapy