Transitional cell carcinoma of the renal pelvis forming tumor thrombus in the vena cava

A 47-year-old man presented with a left renal incidentaloma without hematuria. The tumor was complicated by inferior vena cava, (IVC) thrombus extending from Th-11 to L-4. A temporary IVC filter was introduced prior to surgery. A midline incision was used to perform a left radical nephrectomy and en bloc lymphadenectomy with excision of the inferior vena cava from above the level of the left renal vein to 2.5 cm above the confluence of the common iliac veins. The pathological diagnosis was invasive transitional cell carcinoma. The tumor thrombus consisted of transitional cell carcinoma that histologically invaded the walls of the IVC. He died of cancer 17 months after the operation for the liver metastases. This is the 18th case report of such a presentation in the literature.