Tumor recurrence in the inferior vena cava following radical nephrectomy for renal cell carcinoma: a case report and review

Renal cell carcinoma is a relatively common malignancy in the United States with an estimated incidence of ∼80,000 cases, many of which are found incidentally. Renal cell carcinoma tends to invade vascular structures which can predispose to a host of complications. Although recurrence is common, isolated tumor thrombus recurrence is rare and surgically complex. We report the case of a 70-year-old male with a history of renal cell carcinoma status post nephrectomy 20 years ago who presented with generalized weakness and falls. Imaging revealed an inferior vena cava thrombus and intraluminal biopsy confirmed clear cell renal cell carcinoma. Frequent surveillance is critical for early detection and management of recurrent disease. This case highlights the importance of considering late vascular recurrence even decades after initial treatment.