A diagnostic and management conundrum in a rare case of a small renal mass UTUC with IVC and bilateral renal vein tumour thrombus

Abstract

Upper Tract Urothelial Carcinomas (UTUC) are generally uncommon, accounting for approximately 5% of all urinary tract tumours. This report describes a unique Case of a 52-year-old-male with no known risk factors or symptoms of UTUC, who presented with bilateral sub-massive pulmonary embolus (PE). Subsequent computed tomography (CT) demonstrated a small (<2cm) right cortical based mass a discordant venous tumour thrombus (VTT) extending in the IVC, up to the level of the hepatic vein and bilateral renal veins. The patient had surgical excision in the form of right radical nephroureterectomy, IVC resection with bovine pericardial graft reconstruction and left renal autotransplant.

Keywords

• Upper tract urothelial carcinomas
• Renal vein
• Inferior vena cava
• Tumour thrombus
• Renal autotransplantation
• Neoadjuvant chemotherapy