Surgical site, renal fossa and vena caval recurrence of renal cell carcinoma: an unusual case of late recurrence

A 57-year old male who had undergone a radical nephrectomy for T2NoMo Fuhrman grade III tumour 5 years back developed persistent loin pain. Clinically he had a palpable right hypochondriac mass. Imaging revealed a tumour over the previous surgical scar, renal fossa with inferior vena cava obstruction with no other metastatic disease. He underwent excision of the local recurrence, cavotomy, thrombectomy with caval resection since the tumour was adherent to the IVC. Histology confirmed it as a recurrence of renal cell carcinoma and was followed by targeted therapy.

We report an unusual case of late presentation of surgical site and renal fossa recurrence with invasion to the inferior vena cava (IVC) in a patient who underwent radical nephrectomy for a renal cell carcinoma (RCC). A review of the literature showed no previous published cases of RCC recurring in the surgical site, renal fossa with IVC involvement in combination in a single patient.

DOI: 10.4038/slju.v10i1.2416

Sri Lanka Journal of Urology, 2009, 10, 31-33