PMC4112030_01
Patient 1: Magnetic resonance imaging shows a large heterogeneous mass arising from the left adrenal gland associated with heterogeneous enhancement of the tumor thrombus in the inferior vena cava (arrow).
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Fig1
An abdominal CT-scan and MRI were performed: the size of the mass was 88 x 127 x 140 mm, with solid and necrotic components (Figure 1). CT-scan showed a progression of the tumour which now invaded the renal vein, mesenteric vein and celiac axis as well as the vena cava (Figure 1). Chemotherapy was continued for five cycles.
PMC4112030_02
Radiological and pathological analysis of the tumor of the patient 2. (a) Abdominal CT-scan: large heterogeneous left side mass with a large tumor thrombus in the inferior vena cava (arrow). (b): histology of the renal vein: venous tumor thrombus (25x magnification).
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Fig2
Its centre was necrotic without calcifications (Figure 2a). The histological analysis of the tumor demonstrated the presence of a poorly differentiated neuroblastoma with high MKI with unfavorable histology, and invasion of the renal vein (Figure 2b) and pulmonary metastases.
PMC4112030_03
Radiological and pathological analysis of the tumor of the patient 3. (a) Abdominal CT-scan: large heterogeneous right abdominal mass with a tumor thrombus of the inferior vena (Arrow). (b): Gross examination of the tumor: heterogeneous partially necrotizing tumor of the right adrenal gland. (c): Histology of the tumor: neuroblastoma poorly differentiated (400x magnification).
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Fig3
An abdominal ultrasonography showed a right renal mass with tumour in the right renal vein with extension to the inferior vena cava which was confirmed on the CT-scan (Figure 3a). A right radical nephrectomy, taking care not to disrupt the venous thrombus before excision, was performed with a rapid recovery (Figure 3b). The pathologic examination demonstrated the presence of a poorly differentiated neuroblastoma and intermediate MKI (Figure 3c) and unfavorable histology.