Venous renal tumor extension: a prospective US evaluation.

Abstract

To evaluate the ability of ultrasonography (US) to determine venous tumor extension, we studied 120 consecutive patients with renal neoplasms. The incidence of renal vein involvement in this group was 18%; caval tumor extension occurred in 11% of the patients. Real-time US clearly visualized the entire retrohepatic inferior vena cava (IVC) in 96% of the examinations, and the ipsilateral renal vein was well seen on 88% of the scans. Of the caval sonograms that could be evaluated (115/120), intravascular tumor thrombi were detected in all 13 cases (sensitivity and specificity = 100%). Of the assessable sonograms of the renal vein (105/120), tumor invasion was identified by US in 21 of 22 cases (sensitivity = 95.5%, specificity = 100%). Venous tumor involvement was seen with intravascular lesions of different echogenicity, which caused a neoplastic-induced renal or caval vein enlargement in most cases. Our findings show that US is of great value in the preoperative assessment of intravascular tumor extension and provides a useful alternative to inferior venacavography.

A Prospective Study of the Value of Conventional CT, Dynamic CT, Ultrasonography and Arteriography for Staging Renal Carcinoma

“…Although there have been previous studies of the staging of renal carcinoma by ultrasonography, the majority have examined a single staging criterion such as venous tumour extension (Schwerk et al, 1985) or the "T" stage (Frohmuller etal., 1987). Cronan et al (1982) looked at overall tumour staging by ultrasonography and found it to have an accuracy of 70% (16 of 23 patients).…”

Preoperative Staging of Renal Cell Carcinoma With Inferior Vena Cava Thrombus Using Multidetector CT and MRI

“…If the tumor thrombus involves the intrahepatic portion of the vena cava, ultrasound sensitivity of 100% has been reported in detecting the tumor thrombus. Usually the overall sensitivity of detecting a thrombus is reported from 89 to 100% 13,14 (Fig. 3A).…”

Asymptomatic Leiomyosarcoma of the Inferior Vena Cava

“…When, as in the case on record, an intraluminal mass is incidentally found in the inferior vena cava, the differential diagnosis includes intravenous extension of a renal carcinoma, a fairly frequent phenomenon. In a recent study comprising 120 unselected patients with renal neoplasms, 13 patients (10.8%) had tumor growth into the inferior vena cava (13). Other possibilities when a tumorlike lesion is found in the inferior vena cava are extension into the vessel from thrombosis of pelvic veins and rare occasions of extended growth from intravenous uterine leiomyomatosis (1 8), renal angiomyolipoma (7), xanthogranulomatous pyelonephritis (9), adrenal carcinoma ( 1 1) and pheochromocytoma (12).…”