Synchronous nephrectomy and cavoatrial tumor thrombectomy under normothermic extracorporeal circulation and beating heart

Journal of Surgical Case Reports
Eleftheria MavrigiannakiDionisios Vrochides

Abstract

Formation of tumor thrombus is an occasional manifestation of renal cell carcinoma (RCC). Intravascular invasion of the renal vein and thereafter the inferior vena cava (IVC) might in very rare cases extend into the cardiac chambers. The subtle course and symptoms of such cases alongside with the engagement of vital anatomical structures marks them as a diagnostic and therapeutic challenge. Aggressive surgical intervention has proven to be critical for survival rates in such cases; however total synchronous resection remains a challenge for the surgical team and a debate for the medical community. Following we report the case of a 66-year-old male who was diagnosed with a RCC of the right kidney accompanied by a tumor thrombus extending into the right atrium, after he suffered a presyncope episode. The patient underwent a radical en bloc nephrectomy and tumor thrombectomy under extracorporeal circulation with beating heart.

References

Nov 5, 2011·Current Urology Reports·Javier González
Oct 9, 2015·Therapeutic Advances in Urology·Sarah P Psutka, Bradley C Leibovich
Feb 3, 2016·The Annals of Thoracic Surgery·Mario GaudinoLeonard N Girardi
Mar 27, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Maude Gagné-LorangerFrançois Dagenais
Apr 17, 2017·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Georges M HaidarMark G Davies

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