Fig. 12

An 8-year-old girl with increasing abdominal distension secondary to a malignant germ cell tumour (MGCT). a A sagittal abdominal ultrasound image demonstrates tapering of the upper abdominal inferior vena cava (IVC) (white arrows). b Axial contrast-enhanced CT image at the level of the kidneys demonstrates flattening of the IVC (arrow). There is also a large heterogenous mass in the anterior abdomen containing internal foci of calcification (dashed arrow). c Sagittal CT image of the IVC reveals demonstrates compression of the vessel (black arrows), again placing the patient at risk of poor central venous return