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 hematur ia. The tumor was complicated by inferior vena cava, (IVC) thrombus extendi ng from Th-11 to L-4. A temporary IVC filter was introduced prior to surger y. A midline incision was used to perform a left radical nephrectomy and en bloc lymphadenectomy with excision of the inferior vena cava from above th e 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 car cinoma. The tumor thrombus consisted of transitional cell carcinoma that hi stologically invaded the walls of the IVC. He died of cancer 17 months afte r the operation for the liver metastases. This is the 18th case report of s uch a presentation in the literature.