Polycystic kidneys with seminal megavesicles and duplication of inferior vena cava
Presentation
Underlying polycystic kidney disease. Presented with painless microscopic haematuria.
Patient Data
Both kidneys are enlarged with multiple cysts within, some with wall calcifications and some hyperattenuating on plain scan, suggestive of haemorrhagic cysts. No suspicious renal mass seen. No renal or ureteric calculi. No hydronephrosis or hydroureter bilaterally.
Urinary bladder is normal in outline. Diffuse enlargement of bilateral seminal vesicles. Prostate is not enlarged.
Incidental findings of duplicated left inferior vena cava (IVC) extending from the left common iliac vein, joining the left renal vein near the renal hilum, crossing anterior to the aorta to joint the right-sided inferior vena cava. No circumaortic left renal vein.
Case Discussion
This patient has autosomal dominant polycystic kidney disease (ADPKD), a hereditary form of adult cystic renal disease. Some of the cysts are haemorrhagic, however no CT evidence suspicious of malignancy.
Diffusely enlarged bilateral seminal vesicles may represent cystic dilatation/ectasia of seminal vesicles (megavesicles), which have been reported to be seen in some patients with adult polycystic kidney disease.1,2
It is important to identify anatomical variants such as a duplicated IVC in patients who are candidates for surgery as it may lead to accidental injuries and bleeding complications if not identified prior to surgery.
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