title: Renal vein thrombosis mimicking urinary calculus: a dilemma of diagnosis.
abstract: BACKGROUND
  Renal vein thrombosis (RVT) with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified RVT.
  
  
  METHODS
  A 38-year-old woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. She underwent extracorporeal shock wave lithotripsy that failed, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In preoperative view of the unusual shape of the calculus without hydronephrosis, noncontrast computed tomography was taken and demonstrated left ureteric calculus. However computed tomography angiography revealed, to our surprise, a calcified RVT that was initially thought to be a urinary calculus.
  
  
  CONCLUSIONS
  This case shows that a calcified RVT might mimic a urinary calculus on conventional ultrasonography and ureteric calculus on noncontrast computed tomography. Subsequent computed tomography angiography disclosed that a calcified RVT caused the imaging findings, thus creating a potentially dangerous clinical pitfall. Hence, it is suggested that the possibility of a RVT needs to be considered in the differential diagnosis whenever one detects an uncommon shape for a urinary calculus.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. wangym_in@163.com.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. chensw123@126.com.
authors.forename: Shanwen
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. wangw2002@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Sidney kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 21128, Baltimore, USA. jiliu15@jhmi.edu.
authors.forename: Jianyong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. jinbaiye1964@aliyun.com.
authors.forename: Baiye
authors.initials: B
authors.lastname: Jin
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010690:Phlebography / Q000379:methods*; D012082:Renal Veins / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods; D014545:Urinary Calculi / Q000175:diagnosis*; D061205:Vascular Calcification / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000175:diagnosis*