case_images: PMC10764663_01
case_images: CT images of the right renal tumor on presentation. a CT image showing a 75- x 60-mm right renal tumor. b Contrast-enhanced CT image showing thrombus within the renal vein and a 35-mm-long thrombus in the inferior vena cava
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case_images: Fig1
case_images: The maximum diameter of the venous tumor thrombus (VTT) was 17 mm and of the IVC 26 mm (Fig. 1).
case_images: Photomicrographs of the biopsy specimen. a Hematoxylin-eosin-stained photomicrograph (20 x). Polymorphic heterozygous cells are irregularly abundant and show spindle-shaped and sarcomatoid changes. b Vimentin-stained photomicrograph showing extensive positivity
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case_images: Fig2
case_images: A CT-guided percutaneous tumor biopsy resulted in a pathological diagnosis of sarcomatoid RCC (Fig. 2).
case_images: Images of the right renal tumor 3 months after presentation. a CT image showing a 78- x 76-mm right renal tumor. b Contrast-enhanced CT image showing a thrombus within the renal vein and a 77-mm-long thrombus in the inferior vena cava
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case_images: Fig3
case_images: Immediately before planned surgery, the primary tumor was 78 x 76 mm, maximum diameter of the IVC-VTT 33 mm, and the intra-IVC-VTT 77 mm long, its head reaching the hepatic venous confluence (Fig. 3).
case_images: CT images of the right renal tumor after nivolumab plus ipilimumab (1 year after presentation). a The primary tumor has shrunk to 41 x 40 mm. b The maximum diameter of the thrombus is 8 mm and its length is 26 mm after the chemotherapy
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case_images: PMC10764663_01_13691_2023_627_Fig4_HTML.jpg
case_images: Fig4
case_images: By 1 year after the initial presentation, the primary tumor had shrunk to 41 x 40 mm, the lymph nodes were of normal size, the maximum diameter of the thrombus was 8 mm, and the intra-IVC-VTT was only 26 mm long (Fig. 4).
case_images: Images of resected tumor. a Photograph of the resected specimen (renal tumor and tumor thrombus). There is a large yellowish-white tumor in the kidney, 80% of which shows necrosis and fibrosis. b Hematoxylin-eosin-stained photomicrograph (20 x) showing areas with epithelial connections and areas with sarcomatoid changes
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case_images: Fig5
case_images: The resection margins were negative, and lymphocytic infiltration within the tumor is recognized in some tumor areas (Fig. 5).