Images – Isolated caval recurrence of renal cell carcinoma

Renal cell carcinoma (RCC) is unique in that it has a biological propensity for vascular invasion. Approximately 10% of RCC cases present with venous tumour thrombus involving the renal vein or inferior vena cava (IVC)1,2 and 1% with a thrombus extending into the right atrium.3 Isolated caval recurrence of RCC following radical nephrectomy, however, is a rare event. Although systemic treatment may have a role in managing patients with distant metastases, in the case of local recurrence, surgical intervention remains the only effective treatment.