Incidental finding of right renal venous aneurysm in a patient with symptomatic ipsilateral renal carcinoma: a case report.
BACKGROUND
True venous aneurysms of the renal veins are very uncommon lesions. Diagnosis is incidental, and thrombosed aneurysms may simulate solid renal masses.


RESULTS
A case of right renal vein aneurysm incidentally found in a patient with a ispilateral renal carcinoma and abdominal aortic aneurysm is reported. While CT examination suggested a high-flow arteriovenous (A-V) malformation, a selective angiographic study identified two separate and independent pathologic conditions (venous aneurysm and intratumoral, acquired A-V fistulae). Successful preoperative embolization of the renal tumor was obtained and surgical treatment (nephrectomy+aneurysmectomy) was uneventful.


CONCLUSIONS
Although uncommon, venous renal aneurysms require an accurate preoperative diagnosis; this case is interesting because the coexistence of renal tumor with acquired A-V fistulae raised the prospect of a large, high-flow A-V communication with secondary venous enlargement. The integrated imaging studies were basic to differentiate acquired, tumor-induced A-V fistulae found in the lower renal pole from the true venous aneurysm located in the upper pole. To our knowledge, this is the first report of such a condition.
Ferrante
Angela
A
Vascular Surgery Unit, Department of Cardiovascular Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Rome, Italy. aferrante@rm.unicatt.it
Di Stasi
Carmine
C
Pierconti
Francesco
F
Snider
Francesco
F
D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000150:complications; D001164:Arteriovenous Fistula / Q000150:complications / Q000473:pathology / Q000628:therapy; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000473:pathology; D004621:Embolization, Therapeutic; D007839:Functional Laterality; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008297:Male; D012077:Renal Artery / Q000473:pathology; D012082:Renal Veins / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed