Reconstruction of the inferior vena cava using the right ovarian vein following resection of renal cell carcinoma with tumor thrombus directly infiltrating the inferior vena cava: a case report.

Authors

Hongxing Luo, Minna Zhang, Qiang Li, Zhimin Tang, Haixing Lin

Published in

AME case reports. Volume 10. Pages 213. Epub Sep 14, 2026.

Abstract

Per the 8th American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, renal cell carcinoma (RCC) with full-thickness inferior vena cava (IVC) wall invasion is staged T3c, which requires radical resection combined with venous reconstruction as the only curative treatment. Conventional synthetic vascular grafts carry prominent postoperative thrombotic risks, while reliable autologous venous alternatives specifically for female patients remain limited. This case presents an intraoperative attempt at IVC repair using fistula-dilated autologous right ovarian vein after en bloc excision of tumor and venous tumor thrombus (VTT).
A 58-year-old postmenopausal woman presented with a 2-week palpable right upper abdominal mass. Preoperative imaging confirmed a 10 cm clear cell RCC complicated by level II IVC tumor thrombus and intratumoral arteriovenous fistula-induced ovarian vein dilatation. We performed en bloc resection of the tumor, thrombus and invaded IVC segment, then reconstructed the IVC with an autologous ovarian vein patch. Pathology verified R0-resected pT3cNXM0 International Society of Urological Pathology (ISUP) grade 3 RCC. Standard postoperative anticoagulation was administered. Over 2 years of surveillance, the patient remained free of venous congestion-related symptoms; however, severe imaging artifacts on all serial scans precluded objective evaluation of graft luminal patency, and high-grade IV stenosis or complete occlusion was strongly suspected. The absence of clinical swelling was attributed to compensatory dilatation of the left renal vein and mature systemic venous collateral circulation, which cannot be interpreted as evidence of unobstructed anatomical IVC lumen.
Dilated autologous ovarian vein may serve as a graft-sparing patch material for IVC repair in highly selected female T3c RCC patients complicated by intratumoral arteriovenous fistula. Further clinical studies are needed to validate its value in patients without ovarian vein dilatation.

PMID:
42871392
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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