Role of imaging in successful management of malignant ovarian vein thrombosis in RCC

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. Copyright 2014 BMJ Publishing Group. All rights reserved.