Inferior vena caval thrombus associated with double neoplasms of the retroperitoneum and kidney: report of a case.

We report herein the case of a patient we recently encountered who was found to have a giant retroperitoneal tumor coincident with tumor thrombus in the inferior vena cava (IVC). On the assumption that the origin was retroperitoneal, the two lesions were resected using an intracaval filter. However, histopathological examination of the specimens revealed neurilemoma for the retroperitoneal tumor and adenocarcinoma for the tumor thrombus. A right renal tumor was subsequently detected, which led to right nephrectomy being performed en bloc with part of the IVC using a venoarterial bypass. Microscopy revealed carcinoma of the Bellini duct, or collecting duct, which is an extremely rare tumor. Retrospectively, a lesion with soft tissue density was noted in the renal vein. Surgical management focused on the prevention of pulmonary embolism. We describe this case because of its extreme rarity and its significance from the viewpoint of diagnosis and therapeutic strategies.