Fig. 18

A 13-year-old girl with left-sided Wilms’ tumour and saddle pulmonary embolus. a Axial computed tomographic pulmonary angiogram (CTPA) demonstrates a saddle pulmonary embolus occupying the right and left pulmonary arteries (black arrow). b Axial T2-weighted fat-saturated MR image reveals a left renal mass with tumour thrombus occupying the entire left renal vein (white arrow). c Coronal contrast-enhanced CT image of the abdomen shows the heterogeneously enhancing left renal mass, with internal haemorrhage. There is right-sided displacement of the IVC with the splenic vein (dashed arrows) stretched and draped over the mass