Retrograde venous invasion causing vertebral metastases in renal cell carcinoma

A case of renal cell carcinoma is presented with renal vein and inferior vena cava tumour/thrombus extension and vertebral metastases centred on the basivertebral veins at three contiguous levels in the low thoracic spine. MRI demonstrated tumour in the intervertebral veins, suggesting that the vertebral deposits were due to retrograde venous spread. To our knowledge, vertebral metastatic deposits due to retrograde venous spread in renal cell carcinoma have not been previously demonstrated directly on imaging. A review is given of the venous anatomy relevant to this mode of spread.