Renal cell carcinoma with retro-aortic renal vein thrombus: a case series.
Marsh H., Cranston D., Sullivan M.
OBJECTIVE: To present three cases of tumour thrombus in the retro-aortic renal vein (RARV) arising from left renal cell carcinomas (RCCs), a very rare event (<1:1000-2000 per case) and to discuss the embryological, radiological and surgical aspects of this anomaly. PATIENTS AND METHODS: Three cases of RCC with RARV thrombus presented in a 1-month period at one institution. RESULTS: All three cases were identified before surgery by computed tomography (CT) urograms and had a successful nephrectomy. CONCLUSION: RCC in the presence of RARVs is rare but can be identified on CT urogram. At nephrectomy, a midline laparotomy or full 'rooftop incision' is recommended, and any attempt to mobilize the kidney before dealing with the renal pedicle should be avoided.