Left-sided inferior vena cava

Case contributed by Heba Abdelmonem
Diagnosis certain

Presentation

A patient with hepatoma underwent thermal ablation.

Patient Data

Gender: Male

Abnormal left side position of the inferior cava until the origin of the left renal vein where it crosses the midline in front of the abdominal aorta to regain its normal course. Segment VI post-thermal ablation zone. Non-visualized right kidney.

Case Discussion

The development of the inferior vena cava is based on three sets of paired veins, the subcardinal, supracardinal and postcardinal veins. The posterior cardinal veins gradually regress followed by the dominance of the right supracardinal vein below the level of the renal vein and the subcardinal veins become dominant above the renal veins. A left inferior vena cava develops when the right supracardinal vein becomes atrophic with the dominance of the left supracardinal vein. 

Left sided IVC may be misdiagnosed as enlarged para-aortic lymph nodes.

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