Renal cell carcinoma with local tumor extension and pulmonary tumor embolism captured on hybrid CT and F18-PSMA PET.

A 52-year-old female presented to hospital with acute dyspnea on a background of renal cell carcinoma in remission. Initial CT imaging demonstrated a large volume of acute occlusive pulmonary emboli in segmental and subsegmental arteries. Subsequent prostate-specific membrane antigen positron emission tomography-computed tomography scan was performed identifying the occlusive emboli as tumor thrombus in the renal vein, inferior vena cava and pulmonary arteries. The use of the prostate-specific membrane antigen positron emission tomography scan assisted in the differentiation of tumor thrombus from bland thrombus-allowing for targeted treatment with immunotherapy.