Bilateral Polycystic Kidney Disease and Inferior Vena Cava (IVC) Thrombosis: A Cadaveric Study

Area of Science:

• Nephrology
• Genetics
• Pathology

Background:

• Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disorder, frequently leading to end-stage renal disease.
• Bilateral polycystic kidney disease co-occurring with liver cysts is a rare clinical presentation.

Observation:

• A cadaveric dissection of a 90-year-old Caucasian male revealed enlarged kidneys with multiple cysts and interspersed normal renal tissue.
• The left kidney exhibited larger cysts compared to the right kidney, with partial absence of renal capsules.
• Polycystic liver and an inferior vena cava filter, indicative of prior venous thrombosis, were also noted during dissection.

Findings:

• The case presents a rare combination of bilateral polycystic kidney disease, polycystic liver, and evidence of inferior vena cava thrombosis.
• The findings highlight the potential for complex vascular and hepatic manifestations in advanced ADPKD.
• The presence of an IVC filter suggests a history of venous thromboembolism, a known complication in some ADPKD patients.

Implications:

• This case underscores the importance of considering systemic complications in ADPKD, including vascular events and hepatic involvement.
• Further research into the specific mechanisms linking ADPKD, liver cysts, and thrombosis may improve patient management.
• Such detailed pathological findings contribute to a comprehensive understanding of ADPKD's diverse phenotypic expressions.