Incidental finding of circumaortic left renal vein aneurysm on imaging.

Vascular anomalies of renal veins are rare. They will usually be found incidentally but can present with significant complications. A 59-year-old man had an asymptomatic left renal hilar abnormality found on routine surveillance imaging. Renal ultrasound showed a circumaortic left renal vein fusiform vs saccular-type dilation. Computed tomography demonstrated a left-sided circumaortic renal vein aneurysm (RVA) measuring 2.2 cm × 1.8 cm. The patient was appropriate for surveillance imaging. To the best of our knowledge, one case of a circumaortic RVA managed conservatively has been reported. Our literature review showed that management is determined by the presentation and complications. No consensus has been reached regarding the size of RVAs requiring intervention. Several studies reported managing RVAs nonoperatively with routine surveillance.