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Dramatic and unexpected natural disease processes may occasionally be encountered in the course of routine forensic pathology practice. The pathophysiological consequences of these processes may carry profound medicolegal implications which may have a bearing on the liability and culpability of the various parties involved. A pedestrian-vehicular incident involving a 53-year-old woman in whom a renal adenocarcinoma with tumour extension to the inferior vena cava and right atrium was discovered at autopsy is reported.

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