RENAL-VEIN TO PORTAL-VEIN COLLATERALS IN 3 CASES OF RENAL-CELL CARCINOMA EXTENDING INTO THE INFERIOR VENA-CAVA - CONSEQUENCES FOR CHEMOEMBOLIZATION

Three patients with renal vein and inferior vena cava (IVC) tumor thro mbus from left renal cell carcinoma (RCC) showed Lipiodol deposits in the liver following selective SMANCS (styrene maleic acid neocarzinost atin)/Lipiodol embolization of the renal tumors. In 2 of the 3 patient s, renal-portal communications were demonstrated during selective rena l arteriography. In 1 of these patients, considerable liver dysfunctio n occurred after the second renal chemoembolization and Lipiodol depos its persisted in the liver for about 1 month. We conclude that these a nastomoses need to be considered prior to embolization therapy of pati ents with RCC and tumor thrombus in the renal vein and IVC. Sclerosing substances or larger particles may be better embolic agents in such p atients.