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Background: We present a patient with a diagnosis of tumor within the vena cava inferior, which was detected during screening abdominal ultrasound examination. Case Report: Repeated abdominal ultrasound examination, CT and MRI were performed in order to make diagnosis more precise. Imaging revealed the tumor within the lumen of dilated inferior vena cava, which was significantly obstructed by tumor masses. Final diagnosis was made on the basis of postoperative histopathological and immunohistochemical findings, which confirmed the renal cell carcinoma within the inferior vena cava, without any detectible lesion in kidneys Conclusions: Despite imaging of retroperitoneal tumors allows accurate assessment of morphology and extent of tumor masses, it is often required to perform surgery and histopathological examination to state the final diagnosis.