Left renal vein thrombosis

Case contributed by Mohammad Mujalli
Diagnosis certain

Presentation

Breast cancer treated with chemotherapy and hormonal therapy. Presents to the ER with left loin pain.

Patient Data

Age: 40 years
Gender: Female
ct

The left kidney is enlarged with mild perinephric fluid and fat standing.

There are a few non-obstructing renal stones, but no ureteric or urinary bladder stones.

The left renal and ovarian veins are distended with increased attenuation compatible with venous thrombosis.

ct

There is a filling defect in the left renal and ovarian veins confirming thrombosis.

There are a persistent cortical enhancement and lack of parenchymal enhancement of the left kidney.

Case Discussion

A breast cancer patient being treated with chemotherapy and hormonal therapy is at increased risk for thrombosis.

The non-contrast CT scan shows unilateral renal enlargement, perinephric fat stranding but did not reveal an obstructing stone. The differential includes pyelonephritis and renal vein thrombosis so we performed contrast-enhanced CT scan which confirmed left renal vein thrombosis. The thrombus extends into the left ovarian vein (ovarian vein thrombosis)

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