LONG-TERM SURVIVAL AFTER RIGHT NEPHRECTOMY, CAVAL PROSTHESIS AND FAILED LEFT RENAL-VEIN RECONSTRUCTION, IN MANAGING AN ENORMOUS RETROPERITONEAL TUMOR

The left renal vein is endowed with a rich network of collaterals, the refore distal division does not jeopardize global renal function and t his is true under particularly favourable conditions, even if the righ t kidney is missing. A woman presented with an enormous retroperitonea l liposarcoma and a carcinoma of the breast. She underwent a radical m astectomy and the resection of a 13 kg retroperitoneal tumor which req uired a right nephrectomy, segmental resection of the involved vena ca va and reconstruction with a prosthesis joined to the left renal vein by a bovine carotid graft. This graft thrombosed shortly after surgery , without causing apparent damage to the residual kidney. The patient died 77 months after the operation, from diffuse recurrences of the br east cancer while renal function was never impaired. The left renal ve in may be interrupted distally for many pathologies and then reconstru cted or ligated definitively without renal function failure, even in m onorenal patients if collaterals are well developed.