A rare case of right-sided varicocele in right renal tumor in the absence of venous thrombosis and IVC compression

Abstract Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele. Conclusion The presence of right-sided varicocele should raise a suspicion hidden serious pathological retroperitoneal condition, renal malignancy in particular, and should prompt the treating physician to carry out imaging studies of the retroperitoneum and careful study of the angiographic phase of the CT scan can ascertain the pathogenesis of the varicocele.

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The Value of Preprocedure Computed Tomography for Planning Insertion of Inferior Vena Cava Filters

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2009.11.006 ◽

2010 ◽

Vol 61 (4) ◽

pp. 223-229 ◽

Cited By ~ 5

Author(s):

Jeffrey D. Jaskolka ◽

Rachel P.W. Kwok ◽

Sara H. Gray ◽

Hamid R. Mojibian

Keyword(s):

Computed Tomography ◽

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Vena Cava ◽

Reference Standards ◽

Ivc Filter ◽

Renal Veins ◽

Lumbar Vertebral Body ◽

The Mean

Purpose To determine if valuable information could be obtained from abdominal computed tomography (CT) performed before insertion of an inferior vena cava (IVC) filter. Materials and Methods A retrospective review was performed on IVC filter insertions with a CT performed before the procedure. Cavagram and CT were compared for renal vein and IVC anatomy, the diameter of the IVC, and the prevalence of iliocaval thrombus. Correlations were assessed among 3 reference standards for measuring the IVC at cavography. Results The mean IVC diameter was 23.0 mm on CT. On cavagram the mean IVC diameter was assessed by using 3 reference standards: 20.7 mm, with the catheter tip as a reference; 26.9 mm, with a radiopaque ruler; and 23.4 mm, by using a lumbar vertebral body. There was good correlation among the 3 measures of IVC diameter (Pearson's r = 0.75, P < .0001) but moderate correlation with CT (r = 0.36–0.56, P < .001). The sensitivity of cavagram for detecting retroaortic and circumaortic renal veins was 40% and 0%, respectively. Nineteen accessory renal veins (12.8%) were not seen by cavagram. Thirteen patients (8.8%) had iliocaval thrombus on cavagram, of which 12 (92.3%) were not previously detected by CT. Conclusions CT is more sensitive than cavagram for detection of renal vein variants and the level of the lowest renal vein. Therefore, if available, the CT should be reviewed before placement of an IVC filter to optimize positioning. Cavagram remains the criterion standard for detection of iliocaval thrombosis and is necessary before IVC filter insertion.

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Spontaneous rupture of the ovarian vein in association with nutcracker syndrome: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-03192-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Akihito Yamamoto ◽

Seiryu Kamoi ◽

Shunji Suzuki

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Renal Vein ◽

Spontaneous Rupture ◽

Left Renal Vein ◽

Vena Cava ◽

Vascular Network ◽

Retroperitoneal Hematoma ◽

Nutcracker Syndrome ◽

Ovarian Vein

Abstract Background Nutcracker syndrome is a condition in which the left renal vein is pinched between the abdominal aorta and the superior mesenteric artery, resulting in an increase in renal vein pressure and certain symptoms. We report a very rare case of retroperitoneal hematoma caused by the rupture of varicose veins of the left ovary. Case presentation A 77-year-old Japanese woman, para 7, experienced sudden left lower abdominal pain. She had no history of trauma or treatment complications. Computed tomography revealed a left retroperitoneal hematoma, but her abdominal pain subsided quickly; thus, urgent treatment was not required. We then scheduled her for an assessment regarding the cause of her bleeding. However, 6 days after the pain onset, abdominal pain symptoms recurred, confirming hematoma regrowth. Magnetic resonance imaging and three-dimensional computed tomography revealed an abnormal vascular network from the left side of the uterus to the left adnexa. Subsequent angiography revealed that the retroperitoneal bleeding originated from rupture of the distended left ovarian vein, which caused blood reflux from the left renal vein to the left ovarian vein. Although angiography confirmed a passage between the left renal vein and inferior vena cava, computed tomography showed obvious stenosis in the left renal vein. In accordance with these findings, we diagnosed the cause of the distention and rupture of the left ovarian vein as nutcracker syndrome. She underwent embolization of the left ovarian vein as hemostasis treatment, and had a good course thereafter. Conclusions This is the first report of a spontaneous rupture of the left ovarian vein caused by nutcracker syndrome. Nutcracker syndrome is not yet well known to clinicians and should be considered as part of the differential diagnosis when an abnormal vascular network in the pelvis is found.

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Evaluation of left renal vein and inferior vena cava variations through routine abdominal multi-slice computed tomography

Folia Morphologica ◽

10.5603/fm.2014.0017 ◽

2014 ◽

Vol 73 (2) ◽

pp. 159-163 ◽

Cited By ~ 4

Author(s):

N. Boyaci ◽

E. Karakas ◽

D. S. Dokumacı ◽

S. Yildiz ◽

H. Cece

Keyword(s):

Computed Tomography ◽

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Left Renal Vein ◽

Vena Cava

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Renal Pelvis Carcinoma with Renal Vein or Inferior Vena Cava Involvement Linked to Early-onset Lung Metastasis Based on CT Scan Diagnosis

Anticancer Research ◽

10.21873/anticanres.12583 ◽

2018 ◽

Vol 38 (5) ◽

Keyword(s):

Inferior Vena Cava ◽

Ct Scan ◽

Lung Metastasis ◽

Renal Pelvis ◽

Early Onset ◽

Renal Vein ◽

Inferior Vena ◽

Vena Cava

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Gastrointestinal Mantle Cell Lymphoma: incidental finding on routine CT scan following pneumothorax.

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v2i1.7635 ◽

2013 ◽

Vol 2 (1) ◽

pp. 24-26

Author(s):

Mingma Thsering Sherpa ◽

Damiano Rondelli ◽

Raksha Shrestha

Keyword(s):

Ct Scan ◽

Mantle Cell Lymphoma ◽

Cell Lymphoma ◽

Incidental Finding ◽

Signs And Symptoms ◽

Cell Transplant ◽

Rare Presentation ◽

Hematopoietic Stem ◽

Mantle Cell ◽

Hodgkin's Lymphomas

Gastric mantle cell lymphoma is a rare form of gastrointestinal tumor and represents 2.5–7% of all non-Hodgkin’s lymphomas. A 69-year-old maleadmitted with spontaneous pneumothorax was found to have a gastric masson CT scan. Results of histopathological,immunohistochemical and genetic analysis were consistent with mantle cell lymphoma(MCL).Patient responded well to intensive chemotherapy and subsequent allogeneic hematopoietic stem cell transplant and remains in complete remission.We would like to emphasize that a gastric mass, as in this case can occur as a rare presentation of MCL involving the gastrointestinal tract without any other overt signs and symptoms. Journal of Advances in Internal Medicine 2013;02(01):24-26 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7635

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Primary malignant teratoma of the mediastinum with poor outcome: A case report

Vojnosanitetski pregled ◽

10.2298/vsp160331386s ◽

2018 ◽

Vol 75 (8) ◽

pp. 836-840

Author(s):

Danica Sazdanic-Velikic ◽

Dusan Skrbic ◽

Djordje Povazan ◽

Mirna Djuric ◽

Dejan Vuckovic ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Ct Scan ◽

Superior Vena ◽

Germ Cell Tumors ◽

Disease Patient ◽

Vena Cava ◽

Whole Body ◽

Malignant Teratoma ◽

Mediastinal Tumors

Introduction. About 5%?10% of mediastinal tumors in adults are teratomas and about 85% of them are benign. Case report. We report a case of extragonadal malignant teratoma in a 39-year old man. The computed tomography (CT) scan of the chest revealed the soft-tissue density mass in the middle lobe of the lung. The posterolateral thoracotomy was performed and a mediastinal tumor of 25 cm was completely resected. Histopathological findings confirmed malignant teratoma. One month after the resection the positron emission tomography- computed tomography (PET/CT) scan of the whole body was performed and showed progression of the disease. Patient developed signs of the superior vena cava obstruction and received radiotherapy of the mediastinum and the metastatic lesion of the lumbal vertebra. After radiotherapy, the patient developed paraplegia and urinary incontinence and received the best supportive treatment. Conclusion. Primary extragonadal germ cell tumors have poor prognosis due to their relative chemoresistance and frequent findings of advanced disease after establishing the diagnosis.

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Evaluation of the left renal vein variations and inferior vena cava variations by means of helical computed tomography

Clinical Imaging ◽

10.1016/j.clinimag.2012.09.012 ◽

2013 ◽

Vol 37 (3) ◽

pp. 530-535 ◽

Cited By ~ 9

Author(s):

Alper Dilli ◽

Umit Yasar Ayaz ◽

Hatice Kaplanoğlu ◽

Hakan Saltas ◽

Baki Hekimoglu

Keyword(s):

Computed Tomography ◽

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Left Renal Vein ◽

Vena Cava ◽

Helical Computed Tomography

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Contribution of Computed Tomography Scan to the Diagnosis of Spinal Tuberculosis in 14 Cases in Assaba, Mauritania

Radiology Research and Practice ◽

10.1155/2019/7298301 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Boushab Mohamed Boushab ◽

Noukhoum Kone ◽

Leonardo K. Basco

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Spinal Tuberculosis ◽

Signs And Symptoms ◽

Clinical History ◽

Neurological Complications ◽

Disc Disease ◽

Osteoarticular Tuberculosis ◽

The Mean ◽

Clinical Records

Background. The incidence of tuberculosis has increased in recent years in both developed and developing countries. Objective. This retrospective study aimed to review all cases of spinal tuberculosis diagnosed at the Department of Internal Medicine and Infectious Diseases in Kiffa Regional Hospital and assess the role of computed tomography (CT) scan in establishing definite diagnosis. Patients and Methods. Data were collected from clinical records of patients admitted to the hospital for rachialgia between August 2016 and July 2018. Results. Fourteen (12.2%) adults with spinal tuberculosis were found among 115 patients with all forms of tuberculosis during the study period. The mean (± standard deviation) age of our patients was 47.5 ± 22.0 years old with male:female (8/6) sex ratio of 1.3. The mean duration of evolution of the disease was 15 months. The presenting signs and symptoms included rachialgia in most patients (93%), associated with segmental spinal stiffness (50%) and/or neurological complications (50%). Diagnosis was established on the basis of clinical history, clinical examination, standard vertebral column radiography, and CT scan. Vertebral imaging showed a clear predominance of lumbar lesions (57%), followed by dorsal (36%) and cervical (7%) involvement. The evolution under treatment was favorable, with the exception of two cases of medullary compression. Conclusion. Spinal tuberculosis is the most common form of osteoarticular tuberculosis. It affects predominantly lumbar and dorsal vertebrae. In the absence of histological confirmation, the presence of back pain associated with major radiological signs of spondylosis disc disease seems to justify the use of CT scan to confirm the diagnosis of this pathology.

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Renal vein and vena caval thrombus: a rare presentation of emphysematous pyelonephritis

BMJ Case Reports ◽

10.1136/bcr-2019-231455 ◽

2019 ◽

Vol 12 (9) ◽

pp. e231455

Author(s):

Amit Jain ◽

Ketan Mehra ◽

Ramanitharan Manikandan ◽

Lalgudi Narayanan Dorairajan

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Ivc Thrombus

Emphysematous pyelonephritis (EPN) can present with symptoms due to infection or sepsis. EPN presenting with renal vein and inferior vena cava (IVC) thrombus is very rare. We report a case of EPN with renal vein and IVC thrombus and its management.

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