An anomalous left adrenal vein draining into both the left renal vein and inferior vena cava: A case report

Kodai Fukuda, MD, PhD; Tetsuo Sonomura, MD, PhD; Nobuyuki Higashino, MD, PhD; Ryosuke Mimura, MD; Takao Koyama, MD; Akira Ikoma, MD, PhD; Daiki Sakane, MD; Tomoya Tsuji, MD, PhD; Takaaki Matsuoka, MD, PhD; Hiroki Minamiguchi, MD, PhD

Radiology Case Reports (Oct 2024)

An anomalous left adrenal vein draining into both the left renal vein and inferior vena cava: A case report

Kodai Fukuda, MD, PhD,
Tetsuo Sonomura, MD, PhD,
Nobuyuki Higashino, MD, PhD,
Ryosuke Mimura, MD,
Takao Koyama, MD,
Akira Ikoma, MD, PhD,
Daiki Sakane, MD,
Tomoya Tsuji, MD, PhD,
Takaaki Matsuoka, MD, PhD,
Hiroki Minamiguchi, MD, PhD

Affiliations

Kodai Fukuda, MD, PhD: Department of Radiology, Wakayama Medical University, Wakayama, Japan; Corresponding author.
Tetsuo Sonomura, MD, PhD: Department of Radiology, Wakayama Medical University, Wakayama, Japan
Nobuyuki Higashino, MD, PhD: Department of Radiology, Wakayama Medical University, Wakayama, Japan
Ryosuke Mimura, MD: Department of Radiology, Wakayama Medical University, Wakayama, Japan
Takao Koyama, MD: Department of Radiology, Wakayama Medical University, Wakayama, Japan
Akira Ikoma, MD, PhD: Department of Radiology, Wakayama Medical University, Wakayama, Japan
Daiki Sakane, MD: Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
Tomoya Tsuji, MD, PhD: Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
Takaaki Matsuoka, MD, PhD: Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
Hiroki Minamiguchi, MD, PhD: Department of Radiology, Wakayama Medical University, Wakayama, Japan

Journal volume & issue: Vol. 19, no. 10
pp. 4435 – 4439

Abstract

Read online

A male patient in his forties was diagnosed with primary aldosteronism following blood tests. The patient requested surgical treatment and was transferred to our department for adrenal vein sampling. Preoperative contrast-enhanced computed tomography (CT) revealed that the left adrenal vein (LAV) did not form a common trunk with the left inferior phrenic vein, and instead drained into both the left renal vein (LRV) and inferior vena cava (IVC) after the bifurcation. Angiography from the LAV showed a branch draining into the IVC. Left-sided sampling was performed. Aldosterone levels were elevated at all 3 sites. Because the sampling results were bilaterally positive, the patient was contraindicated for surgery. There are no reports of an anomalous LAV draining into both the LRV and IVC, making this case extremely unique. Regarding the LAV sampling site, it has been reported that aldosterone levels are higher in the common trunk than in the LAV. Therefore, we increased the number of blood sampling sites. In adrenal vein sampling, we often focus on the anatomy of the right adrenal vein because of difficulties in accessing to it. However, anomalies of the LAV may also occur. Therefore, it is important to determine the anatomy of both adrenal veins using preoperative contrast-enhanced CT to plan an appropriate sampling strategy.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

About the journal

Abstract

Keywords