A 54-Year-Old Previously Healthy Man Comes to the Office Due

A 54-year-old previously healthy man comes to the office due to several weeks of leg swelling.  He has had no fever, chest pain, or dyspnea.  The patient has a 40-pack-year smoking history but does not use alcohol or illicit drugs.  He is afebrile and vital signs are within normal limits.  On physical examination, there is symmetric pitting edema of the lower extremities bilaterally.  The abdomen is soft and nondistended.  A mobile left flank mass can be palpated.  There are several vertically oriented tortuous veins on the lower abdominal wall. Which of the following structures is most likely obstructed in this patient?

A) Femoral veins
B) Iliac veins
C) Inferior vena cava
D) Portal vein
E) Saphenous veins

Correct Answer:

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