Circumferential Resection of the Inferior Vena Cava for Primary and Recurrent Malignant Tumors

Caso, Jorge; Seigne, John D.; Back, Martin R.; Spiess, Phillippe E.; Pow‐Sang, Julio M.; Sexton, Wade J.

doi:10.1016/j.juro.2009.05.015

Cited by 34 publications

(14 citation statements)

References 15 publications

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“…Test clamping is crucial because a sudden dip in the systolic blood pressure to approximately 80 mmHg would occur due to a sudden significant decrease in venous return in the case of poor collateral circulation 20,21 . Complete IVC occlusion without edema of the lower extremities post-operatively could be a predictor of the need for IVC reconstruction 22 . In our patient, he presented with no signs of lower limb edema.…”

Section: Discussionmentioning

confidence: 49%

Renal pelvis squamous cell carcinoma with inferior vena cava infiltration: Case report and review of the literature

Zhang

Ch’ng

Chong

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONRenal squamous cell carcinoma (RSCC) is a rare tumor that is usually diagnosed late as a locally advanced malignancy with adjacent structure involvement. Radical surgical resection with negative margins is the mainstay of treatment, as it is correlated with improved survival, while other modalities of treatment have been shown to have limited efficacy.PRESENTATION OF CASEWe report a case of a 56 year old gentleman with right RSCC with tumor encasing the inferior vena cava (IVC), treated successfully with surgical resection.DISCUSSIONThe surgical management of vascular involvement of similar tumors has not been discussed in-depth in the literature. Surgical resection of the IVC without reconstruction can be done successfully in the circumstance of good collateral circulation; otherwise IVC resection with reconstruction will be necessary.CONCLUSIONRadical resection with clear margins of RSCC tumors with vascular involvement is feasible in selected circumstances.

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Section: Discussionmentioning

confidence: 49%

Renal pelvis squamous cell carcinoma with inferior vena cava infiltration: Case report and review of the literature

Zhang

Ch’ng

Chong

et al. 2014

International Journal of Surgery Case Reports

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“…Clinically, venous obstruction can be evident by lower extremity oedema and the development of dilated abdominal wall venous collaterals. Radiographic evaluation is more precise and could provide evidence of peripheral network venous collaterals such as dilated azygos‐hemiazygos and lumbar veins [11]. Patients with chronic obstruction of the IVC have less haemodynamic instability than those with acute obstruction.…”

Section: Discussionmentioning

confidence: 99%

Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption

Ayyathurai¹,

Garcia-Roig²,

Gorin³

et al. 2012

BJU International

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E 4 4 9What ' s known on the subject? and What does the study add? The surgical implications of renal cell carcinoma with coexisting bland and tumour thrombi of the inferior vena cava is not well described. In this study we review our experience managing these tumours. On multivariate analysis, we found that the presence of bland thrombus was associated with an increased need for surgical interruption of the inferior vena cava. OBJECTIVE• To study the role of interruption of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC) and associated bland and tumour thrombi. METHODS• We reviewed 129 consecutive patients with the preoperative diagnosis of RCC with tumour thrombus who underwent radical nephrectomy and tumour thrombectomy in one academic institution between May 1997 and February 2011. RESULTS• Percentages of patients with levels I, II, III and IV tumour thrombus were 29%, 13%, 48% and 9%, respectively.• The perioperative mortality rate was 2.3%. There were 29 (22%) perioperative complications recorded.• In all, 19 patients underwent surgical interruption of the IVC by ligation or segmental resection, including one level II, 14 level III and four level IV thrombi.• A total of 15 patients (12%) had bland thrombus associated with the tumour thrombus; four of these underwent intraoperative IVC fi lter placement and eight underwent surgical IVC interruption.• Advanced level of tumour thrombus was the only signifi cant factor predicting association of bland thrombus (odds ratio [ OR ] = 2.09, 95% confi dence interval [ CI ] : 1.082 -4.037, P = 0.028).• On multivariate analysis, level of thrombus (OR = 3.1, 95% CI: 1.30 -7.74, P = 0.011) and association of bland thrombus (OR = 9.07, 95% CI: 2.42 -34.01, P = 0.001) were signifi cant factors for IVC interruption. CONCLUSIONS• Surgical interruption of the IVC is a feasible option in selected patients with chronic IVC obstruction. Association of bland thrombus with tumour thrombus should alert the surgical team to the potential for a challenging surgery.• Precise preoperative imaging to assess the degree of venous obstruction and to help with differentiation between bland and tumour thrombus is key to achieving a surgical outcome with minimal morbidity. KEYWORDSrenal tumour , tumour thrombus , inferior vena cava fi lter , pulmonary emboli , tumour thrombus emboli , bland thrombus emboli Study Type -Therapy (case series) Level of Evidence 4

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“…We also performed a PubMed literature search of the past 10 years by entering the search terms ‘leiomyosarcoma’ and ‘inferior vena cava’ [3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, …”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

Fujita¹,

Takahashi²,

Kanzaki³

et al. 2016

Case Rep Oncol

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A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin) followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

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Circumferential Resection of the Inferior Vena Cava for Primary and Recurrent Malignant Tumors

Cited by 34 publications

References 15 publications

Renal pelvis squamous cell carcinoma with inferior vena cava infiltration: Case report and review of the literature

Renal pelvis squamous cell carcinoma with inferior vena cava infiltration: Case report and review of the literature

Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

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