Venous thromboembolism and renal cell carcinoma

There is a vast amount of literature documenting the relationship between cancer and venous thromboembolism. Nevertheless, many aspects of this association remain obscure and the best approach to be taken towards a patient with apparently idiopathic venous thromboembolism has yet to be defined. We present a case of a patient with venous thromboembolism in whom abdominal ultrasonography, prescribed as a cautionary measure to rule out the presence of a tumour, revealed liver metastases, while the subsequent CAT scan showed hepatic angiomatosis and two small bilateral renal carcinomas. Although there are as yet no indications in the literature on screening patients with idiopathic venous thromboembolism for occult tumours, our case shows how the clinical decision to perform abdominal ultrasonography saved the patient's life.