A rare case of transitional cell carcinoma (TCC) with extension into the renal vein and inferior vena cava (IVC) is presented. Computed tomography, magnetic resonance imaging, and angiography successfully delineated tumor thrombus in the right renal vein and IVC. TCC should be included in the differ
Infra-renal angles, entry into inferior vena cava and vertebral levels of renal veins
✍ Scribed by Satyapal, K. S.
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 238 KB
- Volume
- 256
- Category
- Article
- ISSN
- 0003-276X
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✦ Synopsis
Current norms for renal vasculature hold true in only half the population. Standard textbooks perpetuate old misconceptions regarding renal venous anatomy. This study is aimed to determine left and right infra-renal angles (L-IRA, R-IRA); entry level of renal veins into the inferior vena cava (IVC), and height of IVC under renal vein influence; and their vertebral level. One hundred morphologically normal en-bloc renal specimens randomly selected from post-mortem examinations were dissected and resin casted. IRA were also measured from venograms of 32 adult and 11 foetal cadavers, as were vertebral entry levels. IRA measurements (degrees) were as follows: left, 55°Ϯ 16°(20°-102°); right, 60°Ϯ 17°(10°-93°). Left vein entered IVC higher than right 54%, lower 36%, and opposite each other 10%. Vertical distance between lower borders of veins was 1.0 Ϯ 0.9 cm. Vertical distance of IVC under renal vein influence was 2.3 Ϯ 1.0 cm. Vertebral level of veins in adults lies between TI2-L2. In foetuses, IRA was as follows: left, 65°Ϯ 12°(45°-90°); right, 58°Ϯ 7°(40°-70°); vertebral level between T12 and L3. Similar IRA values from literature noted on right, 51°(26°-100°); differences on left, 77°(43°-94°), clearly differing from Williams et al. (Gray's Anatomy, 37 th ed, 1989) statement that renal veins ''open into the inferior vena cava almost at right angles.'' Large variations of IRA are not surprising since kidneys are considered normally ''floating viscera,'' varying position with posture and respiratory movement as well as in live vs. cadaveric subjects. The entry level into the IVC also differs from Williams et al. This study uniquely quantitated actual height difference between lower borders of left and right veins. The data presented appears to be the first documentation of vertebral level of entry of renal veins into IVC in foetuses. These findings are clinically important for the angiographer, catheter design, and planning porto-renal shunt procedures.
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## Abstract Forty‐seven patients with renal cell carcinoma with tumor thrombus extension to the renal vein or inferior vena cava (IVC) were treated surgically over a 10‐year period. There were 41 males and 6 females with a mean age of 45.7 years. Thirty‐three patients had right‐sided and 14 had lef