Multidetector computed tomography (MDCT) and Doppler ultrasound findings of a renal cell carcinoma invading the right ovarian vein are presented. An MDCT study performed for evaluation of macroscopic hematuria showed a heterogeneously enhancing malignant thrombus in the right ovarian vein that was in continuity with inferior vena cava and right renal vein thrombi of identical characteristics. Further investigation with Doppler ultrasound confirmed these findings and showed arterial blood flow of low resistance within the ovarian vein and inferior vena cava thrombi. To the authors knowledge, this is the first report of MDCT and Doppler ultrasound findings of a renal cell carcinoma invading the right ovarian vein.
Renal cell carcinoma (RCC) is the most common primary tumor of the kidney, with more than 30,000 new cases diagnosed in the United States annually.1 This tumor has the propensity to extend into the renal vein and inferior vena cava (IVC); hence accurate preoperative detection of venous spread and its extension is crucial for aggressive surgical resection in patients without nodal or distant metastases.12 We present the multidetector computed tomography (MDCT) and ultrasound Doppler findings of a patient with an extremely large RCC that invaded the entire length of the right ovarian vein as well as the ipsilateral and contralateral renal veins, right hepatic vein, IVC, and right atrium. To our knowledge this is the first documentation of ovarian vein invasion by RCC.