Inferior Vena Cava Tumour Thrombus from Nonseminomatous Germ Cell Tumour Detected with F-18 FDG PET/CT

21-year-old male presented with recently diagnosed metastatic nonseminomatous germ cell tumour and left orchidectomy. CT demonstrated mixed density in the inferior vena cava (IVC) extending from the union of the common iliac veins to the level of the liver just below the confluence of the hepatic veins. Retroperitoneal nodal disease and deposits in the left lung were suspicious for metastatic deposits. F-18Flurodeoxyglucose (FDG) PET/CT images demonstrated avid FDG uptake within the lumen of the IVC from the level of the renal veins, with extension into both renal veins, to the level of T10. While benign and malignant thrombi have previously been demonstrated on F18-FDG PET imaging, this case highlights the use of F-18 FDG PET/CT when identifying tumour thrombosis in patients with nonseminomatous germ cell tumour.