Vascular Anomalies in Patients Undergoing Retroperitoneal Lymph Node Dissection (RPLND) for Testicular Germ Cell Tumours (TGCT)

  • A. Heidenreich
  • A. Elert
Conference paper

Abstract

Primary and secondary RPLND is an established staging and therapeutic procedure for the management of clinical stage I — IIB TGCT and for the resection of residual retroperitoneal masses post chemotherapy. However, RPLND might be complicated by vascular anomalies in the retroperitoneum. Anomalies of the renal vessels usually are clinically silent and might be demonstrated during CT scanning of the abdomen for staging of urological malignancies. Awareness of these rare anomalies is crucial especially in patients undergoing staging for TGCT in order to avoid over-staging and unnecessary therapy. In patients with advanced TGCT, the inferior vena cava (IVC) may be partially or completely occluded by extrinsic compression by lymph nodes or by direct invasion by metastases. Knowledge of the presence and extent of IVC thrombosis is essential to plan the surgical approach. We therefore report on the incidence of renal vessel anomalies and IVC changes in an unselected group of patients undergoing RPLND for testis cancer.

References

  1. 1.
    Höltl W, Hruby W, Aharinejad S. Renal vein anatomy and its implications for retroperitoneal surgery.J Urol 1990; 143:1108.Google Scholar
  2. 2.
    Moul JW, Maggio MI, Hardy MR, Hartman DS. Retroaortic left renal vein in testicular cancer patient: potential staging and treatment pitfall. J Urol 1992; 147: 454.PubMedGoogle Scholar
  3. 3.
    Husband JES, Padhani AR, Long MA, Horwich A, Hendry WF, Dearnaley DP. Evaluation by magnetic resonance imaging of the inferior vena cava in patients with non-seminomatous germ cell tumors of the testis metastatic to the retroperitoneum. Brit J Urol 1997;79: 942.PubMedCrossRefGoogle Scholar
  4. 4.
    Heidenreich A, Derakshani P, Neubauer S, Krug B, Engelmann UH. Evaluation of the inferior vena cava by magnetic resonance imaging in advanced testicular germ cell tumors. Eur Urol 1998;33 (Suppl 1): S49,#196.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2002

Authors and Affiliations

  • A. Heidenreich
    • 1
  • A. Elert
    • 1
  1. 1.Department of UrologyPhilipps-Universität, BaldingerstrasseMarburgGermany

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