January 2008

Abnormal aspect of the inferior vena cava

Clinical Info

Hematuria

Ultrasound Images & Clips

71 year old male, Hematuria

Longitudinal image of the inferior vena cava with soft tissue structures
Longitudinal image of the inferior vena cava with soft tissue structures
Transverse image of the inferior vena cava with soft tissue structures
Transverse image of the inferior vena cava with soft tissue structures
Longitudinal image of the right renal vein filled with soft tissue structures, slightly lateral to the inferior vena cava
Longitudinal image of the right renal vein filled with soft tissue structures, slightly lateral to the inferior vena cava
Transverse image of the right renal vein and inferior vena cava with soft tissue structures
Transverse image of the right renal vein and inferior vena cava with soft tissue structures
Longitudinal image of the right kidney with a large tumor mass in the lowerpole
Longitudinal image of the right kidney with a large tumor mass in the lowerpole
CT scan at the level of the right reanal vein with tumor thrombus in the renal vein and the inferior vena cava
CT scan at the level of the right reanal vein with tumor thrombus in the renal vein and the inferior vena cava
CT scan showing the large renal cell tumor

Diagnosis: Renal cell carcinoma invading the renal vein and inferior vena cava

Renal cell tumors in the right kidney invade the inferior vena cava through the renal vein sooner than renal cell tumors on the left side. In case of tumor invasion of the left renal vein in males, impaired venous drainage of the left spermatic vein can occor, resulting in a varicocele. Also in case of tumor thrombus it is often possible to detect tumor vascularization with color doppler, as is shown in the next patient with a large renal cell carcinoma on the left side, who presented with a large varicocele.
CT scan showing the large renal cell tumor Diagnosis: Renal cell carcinoma invading the renal vein and inferior vena cava Renal cell tumors in the right kidney invade the inferior vena cava through the renal vein sooner than renal cell tumors on the left side. In case of tumor invasion of the left renal vein in males, impaired venous drainage of the left spermatic vein can occor, resulting in a varicocele. Also in case of tumor thrombus it is often possible to detect tumor vascularization with color doppler, as is shown in the next patient with a large renal cell carcinoma on the left side, who presented with a large varicocele.
Transverse image with a dilatated left renal vein filled with tumor thrombus
Transverse image with a dilatated left renal vein filled with tumor thrombus
Color doppler showing tumor vascularization
Color doppler showing tumor vascularization
The patient presented with a large varicocele on the left side
The patient presented with a large varicocele on the left side

Conclusion

References            
Schwerk WB, Schwerk WN, Rodeck G. Venous renal tumor extension: a prospective US evaluation. Radiology. 1985 Aug;156(2):491-5


Details

  • Sex: Male
  • Age: 71

Created with

  • Hitachi Ultrasound System