Transitional cell carcinoma of the kidney with invasion into the renal vein

Eight cases of transitional cell carcinoma with extension into the renal vein are presented. In 2 cases the tumor had also invaded the inferior vena cava. Venous invasion represents an uncommon, late finding of transitional cell carcinoma and is associated with a poor prognosis. The excretory urogram usually demonstrates nonfunction or a pelvic mass with extensive renal invasion. As these findings are nonspecific, definitive preoperative diagnosis is dependent on direct visualization of the renal vein utilizing sonography, computed tomography, or venography. Since vascular invasion is a late finding, venous evaluation is required only in advanced cases of transitional cell carcinoma.