Retroperitoneal lymph node dissection for testicular cancer in a patient with a double inferior vena cava.

INTRODUCTION:A double inferior vena cava is a rare anomaly with an incidence ranging from 0.3% to 3.0%. In patients with a double inferior vena cava, it is important to understand the precise anatomy and possible irregular lymph node flow when performing surgery for malignancies. CASE PRESENTATION:A 60-year-old man with a non-seminoma was referred to our hospital after left high orchiectomy. Computed tomography revealed a double inferior vena cava and swollen masses in the para-aortic region. After four cycles of chemotherapy with etoposide and cisplatin, retroperitoneal lymph node dissection was safely performed with a modified template extended to the right side of the paracaval region by referring to three-dimensional images created by SYNAPSE VINCENT® software. CONCLUSION:Preoperative three-dimensional images were useful to understand this patient's unusual and complicated anatomical positions.