Figure 2a.  (a) Contrast material–enhanced CT scan of the chest demonstrates a large mass within the right atrium with focal areas of enhancement (arrowheads). The azygos and hemiazygos veins are enlarged (arrows). There are small, bilateral pleural effusions, and the right hemidiaphragm is elevated secondary to an enlarged liver. (b) Contrast-enhanced CT scan of the upper abdomen shows a large, mildly enhancing mass within the hepatic portion of the IVC (arrowheads) extending into the liver. The mass is seen compressing the portal vein and obstructing hepatic venous outflow. The hepatic veins are not enhanced, and there is mottled enhancement of the liver parenchyma. (c) Contrast-enhanced CT scan of the lower abdomen shows a tumor within the IVC and enhancement of the IVC wall (arrowhead). There is an area of soft-tissue attenuation surrounding the retroperitoneal vascular structures as well as mesenteric venous congestion and mild anasarca of the abdominal wall soft tissues (arrows).