Renal Cell Carcinoma has a biologic predisposition for direct vascular invasion: intravascular tumor
thrombus is found in 5% to 20% of the cases inside the renal vein or the inferior vena cava. Despite
new and effective conservative therapy such as targeted therapy and immunotherapy, cytoreductive
nephrectomy and palliative nephrectomy continues to have an important role in T4 patient. The
patient selection for cytoreductive nephrectomy should be done carefully.
This report present an unique case of metastatic RCC with invasion of the duodenum, liver and
retrohepatic IVC, the adopted surgical approach and a review of the literature.
Complete surgical extirpation is possible in cases of RCC invading other organs such as pancreas,
duodenum, liver, retroperitoneum and IVC. In this scenario, to narrow the possible intraoperative
complication, a multidisciplinary approach and equipe is recommended