Possible misinterpretation on computed tomography of left inferior vena cava as retroperitoneal lymph node metastasis: a report of two cases

Int J Urol. 1999 Apr;6(4):215-8. doi: 10.1046/j.1442-2042.1999.06445.x.

Abstract

Purpose: We report on two cases of retroperitoneal lymph node metastasis of testicular cancer with left inferior vena cava.

Methods/results: A 25-year-old man with a left testicular cancer with pulmonary and retroperitoneal lymph node metastases received three courses of VIP (etoposide, ifosfamide and cisplatinum) chemotherapy. Subsequent abdominal computed tomography (CT) revealed round lesions enhanced with contrast agent on both sides of the aorta inside the degenerated lymphadenopathy. These lesions were regarded as a duplicated inferior vena cava (IVC) and this was confirmed at retroperitoneal lymph node dissection. The second case is of a 21-year-old man with a left testicular cancer with pulmonary, liver and widespread lymph node metastases. Subsequent to a course of VIP chemotherapy, super high-dose chemotherapy was administered. Abdominal CT revealed a round mass enhanced with contrast agent on the left side of the aorta adjacent to the degenerated lymphadenopathy, which was regarded as the transposed left IVC and this was confirmed at lymph node dissection.

Conclusions: In both cases, initial CT failed to detect the lesions as the left IVC and there was a possibility for the misinterpretation of such venous anomalies with residual lymphadenopathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnostic Errors
  • Humans
  • Lymphatic Diseases / diagnostic imaging
  • Lymphatic Metastasis / diagnostic imaging*
  • Male
  • Retroperitoneal Neoplasms / diagnostic imaging*
  • Retroperitoneal Neoplasms / secondary*
  • Tomography, X-Ray Computed / standards*
  • Vena Cava, Inferior / diagnostic imaging*