Goyal Ankur, Rangarajan Krithika, Singh Prabhjot, Das Chandan Jyoti
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
BMJ Case Rep. 2014 Feb 7;2014:bcr2013201576. doi: 10.1136/bcr-2013-201576.
Renal cell carcinoma (RCC) is the most common renal malignancy in adults. Since complete surgical resection is the treatment of choice, accurate staging and extent delineation are imperative for optimal management. Owing to venous tropism, the tumour has a propensity to extend into renal vein and/or inferior vena cava. However, contiguous gonadal vein extension has rarely been reported. Here we present an unusual case of a 65-year-old woman who demonstrated a large left renal mass with extension of tumour thrombus into the left renal and ovarian veins with multiple retroperitoneal venous collaterals detected on multiphasic CT examination. This preoperative imaging information facilitated en bloc resection of the tumour and thrombosed vessels. To the best of our knowledge, this is the first case where comprehensive imaging evaluation enabled successful surgical management of RCC with malignant ovarian vein thrombosis and limited peroperative complications.
肾细胞癌（RCC）是成人中最常见的肾脏恶性肿瘤。由于完整的手术切除是首选治疗方法，准确分期和范围界定对于优化治疗至关重要。由于肿瘤具有静脉嗜性，它易于延伸至肾静脉和/或下腔静脉。然而，肿瘤连续延伸至性腺静脉的情况鲜有报道。在此，我们报告一例罕见病例，一名65岁女性，其左肾有一巨大肿块，肿瘤血栓延伸至左肾静脉和卵巢静脉，多期CT检查发现多个腹膜后静脉侧支。术前这些影像学信息有助于整块切除肿瘤及血栓形成的血管。据我们所知，这是首例通过全面影像学评估成功实施手术治疗伴有恶性卵巢静脉血栓形成的肾细胞癌且术中并发症有限的病例。
