Figure 1: Computed tomographic images of the patient. (a) Coronal section shows a large heterogeneous mass in the right hypochondrium and lumbar region extending into right atrium. (b) The mass is invading the right renal cortex. Necrotic areas are represented by the internal non enhancing areas. (c) Renal hilar vessels are displaced posteriorly by the mass lesion. (d) Right atrial extension of the mass is seen as filling defect in the contrast filled cardiac chamber. (e) Hepatic parenchyma is infiltrated by the mass with prominent azygous-hemiazygous system. (f) Prominent azygous vein is seen joining superior vena cava representing collateral channels becoming prominent due to inferior vena cava obstruction