Giant Ascending Aorta Aneurysm (AAA) is a rare condition, because of early diagnosis incidence appears to be increasing as a result of routine screening, increased clinical awareness, and improved imaging modalities. The etiology of aneurysms involving the aortic root and ascending aorta can be genetically triggered, degenerative or atherosclerotic, inflammatory, or can result from infectious diseases. According to many studies for ascending aortic aneurysms larger than 6 cm the risk of rupture, dissection, or deaths was 15.6, making it a large life-threatening aneurysm. We present the case of a Giant AAA of about 8,7 cm diameter in a 68 years old man who was successfully operated on for ascending aorta and aortic root replacement under modified Bentall technique using composite mechanical conduit with coronary reimplantation. Conclusion; Ascending giant aortic aneurysm is a rare finding, varying from asymptomatic clinical presentation. Surgical treatment remains the standard treatment with very good results. The selection of the operating technique is very individual, depending on the case and the experience of the surgeon.
BACKGROUND: Renal cell carcinoma (RCC) with cavoatrial involvement represents a major surgical challenge. Several surgical techniques for the treatment of these tumors have been proposed, but due to a small number of patients and limited follow-up, substantial controversy about the best operative management still exists. CASE REPORT: A 54-year-old woman, with no previous comorbidities, comes to the emergency room with low back pain, weight loss, and edema of the lower legs that computed tomography revealed a massive infiltrative expansive formation in the abdomen that affected practically the entire right kidney, measuring 8.2 cm × 7.6 cm that invaded the collecting system and was in close contact with the right hepatic lobe and the head of the pancreas. During the intervention, infiltration of the renal vein on this side is found, and the inferior vena cava (IVC) that extends in its intrahepatic part, up to the junction of the suprahepatic veins, with almost complete closure of the lumen accompanied by the presence of retroperitoneal lymph nodes, with size up to 10 mm. CONCLUSION: Advanced extension of RCC can occur with no apparent symptoms and be detected incidentally. In rare circumstances, atypical presentation of RCC should be considered in a patient presenting with the right atrial mass detected by echocardiography. RCC with IVC and right atrium extension is a complex surgical challenge, but excellent results can be obtained with proper patient selection, meticulous surgical techniques, and close perioperative patient care.
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