Inferior vena caval tumor extension in renal cell carcinoma.

Tumor extension into the inferior vena cava occurs in 4-10% of renal cell carcinomas. The presence of such inferior vena caval involvement by tumor may be considered the only extrarenal manifestation of renal cell carcinoma which does not significantly affect prognosis which is determined by lymphatic and blood-spread distant metastasis. The indication for operation should therefore not be restricted by the presence of tumor in the inferior vena cava, but the operative approach is influenced by the extent of the tumor thrombus. For this reason, precise preoperative diagnosis is crucial.