Intracaval germ cell tumor thrombus.

A 24-year-old male with mixed germ cell tumor after orchiectomy received chemotherapy for abdominal and thoracic lymphadenopathy. Follow-up imaging revealed residual disease in the retroperitoneum as well as thrombus within his inferior vena cava. At surgery, the mass was palpable within the inferior vena cava. After vascular control both proximal and distal to the intraluminal mass, a cavotomy allowed extraction of the thrombus. Final pathologic evaluation of the mass revealed mature teratoma. The surgeon must remain vigilant to the possibility of caval thrombus and be prepared for surgical removal in the cases of advanced germ cell tumors.