A 65 yr old male presents with abdominal pain. Contrast-enhanced CT images of the abdomen and pelvis are shown below. Discuss the diagnosis and management plans.

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Large necrotic heterogenous soft tissue density retroeritoneal mass involving the IVC with focal hypoattenuation of mid segment of liver..... Likely tumor involving IVC with budd chiari syndrome Possibility of leimyosarcoma of IVC Neurogenic tumor involving IVC ...ganglioneroma Adv MRI
There is a well defined lobulated heterogenous mass in the porta hepatis region with non visualisation of IVC s/o Tumour thrombosis with wedge shaped hypoattenuating area seen involving segment no 6 of rt lobe s/o ? Infarct
Looks like an IVC sarcoma involving the left lobe of liver
Retro peritoneal sarcoma, advised FNAC.
Rule out adrenal neoplastic pathology
Its Retroperitoneal sarcoma.
D/d include: Retroperitoneal sarcoma, Hepatocellular carcinoma, Lymphoma, Metastatic disease, Adrenocortical carcinoma, Paraganglioma.
There is a mass centered in Inferior vena cava.
Ivc leomyosarcoma with features of budd charie
Could it be blood clot? May need exploration
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