title: Renal cell carcinoma with retro-aortic renal vein thrombus: a case series.
abstract: OBJECTIVE
  To present three cases of tumour thrombus in the retro-aortic renal vein (RARV) arising from left renal cell carcinomas (RCCs), a very rare event (<1:1000-2000 per case) and to discuss the embryological, radiological and surgical aspects of this anomaly.
  
  
  METHODS
  Three cases of RCC with RARV thrombus presented in a 1-month period at one institution.
  
  
  RESULTS
  All three cases were identified before surgery by computed tomography (CT) urograms and had a successful nephrectomy.
  
  
  CONCLUSIONS
  RCC in the presence of RARVs is rare but can be identified on CT urogram. At nephrectomy, a midline laparotomy or full 'rooftop incision' is recommended, and any attempt to mobilize the kidney before dealing with the renal pedicle should be avoided.
authors.affiliation: Department of Urology, Medway Maritime Hospital, Gillingham, Kent, UK. howard.marsh@medway.nhs.uk
authors.forename: Howard
authors.initials: H
authors.lastname: Marsh
authors.forename: David
authors.initials: D
authors.lastname: Cranston
authors.forename: Mark
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D000368:Aged; D001011:Aorta; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy / Q000379:methods*; D012082:Renal Veins; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*