Recognizing a duplicated inferior vena cava during radical nephrectomy for papillary renal cell carcinoma: A case report

Duplication of the inferior vena cava (DIVC) is a rare congenital venous anomaly with important implications during retroperitoneal surgery. A 40-year-old man presented with 3-month hematuria and mild left flank pain. CT revealed a 7-cm left renal mass, pulmonary and osseous lesions, and two separate IVC channels near the aortic bifurcation. PET/CT confirmed DIVC and suspected metastases. Open radical nephrectomy with lymph-node dissection was performed without vascular injury. Histopathology showed papillary renal cell carcinoma, ISUP grade 3, confined to the renal capsule. This case highlights the importance of recognizing DIVC before renal surgery.