Objectives: To report and discuss four cases of renal cell carcinoma (RCC) in which intraoperative ultrasound was useful to provide accurate information to identify the location and dimensions of vena caval tumour thrombus, thus allowing to perform the most suitable operative procedure.
Materials and methods: We reviewed the cases of four patients with renal cell carcinoma in which preoperative imaging studies demonstrated a vena caval tumour thrombus and that underwent intraoperative ultrasound imaging. We also reviewed the literature applying to this clinical situation.
Results: Intraoperative ultrasound identified correctly the limits of a known thrombus in all patients. Preoperative imaging studies overestimated the precise extent of the thrombus in one patient while the dimension was underestimated in another case.
Conclusion: Intraoperative ultrasound is a very useful tool that can accurately assess the precise extent of tumour thrombus in order to plan an optimal surgical approach. According to our experience it identifies the extent of a known thrombus more correctly than preoperative imaging studies.