Kidney tumour mimicking cardiac mass

Asensio, Juan Manuel Nogales; González-Fernández, Reyes; Bravo, Manuela Alonso; Herrera, Antonio Merchán

doi:10.1016/j.ijcard.2004.12.086

Cited by 6 publications

(2 citation statements)

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“…This technique enables safe and exact extraction of the tumour thrombus in a bloodless operative field and eliminates the risk of leaving residual tumour fragments adherent to the wall of the inferior vena cava or even free fragments inside the right atrium. The same conclusion is supported by published case reports [3–6] and series of four to 21 patients operated with use of CPB and DHCA [7–16].…”

Section: Discussionsupporting

confidence: 54%

Long‐term survival after radical surgery for renal cell carcinoma with tumour thrombus extension into the right atrium

Dominik¹,

Morávek²,

Žáček³

et al. 2012

BJU International

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E 5 9What ' s known on the subject? and What does the study add? Surgical treatment of renal cell carcinoma (RCC) with tumour thrombus extending into the right atrium remains, despite its complexity and specifi c technical aspects, the only radical therapeutic option.This single-centre study, unique in size for this rare condition, reports early and late results over a period of 18 years. All patients were operated on using a standardised protocol with use of cardiopulmonary bypass and deep hypothermic circulatory arrest. Overall and cancer-specifi c cumulative survival was better than in other reports. OBJECTIVE• To evaluate the long-term results of radical surgical management of renal cell carcinoma (RCC) with tumour thrombus extension (TTE) level IV into the right atrium (RCC/TTE IV) in a large singleinstitution series. PATIENTS AND METHODS• Radical complex urological and cardio-surgical procedure was performed over a period of 18 years (1993 -2010) on 21 patients with RCC/TTE IV. A radical nephrectomy was performed followed by sternotomy, institution of cardiopulmonary bypass and extraction of the intracardiac tumour thrombus under direct visual control during deep hypothermic circulatory arrest (DHCA).• Perioperative and postoperative variables, and long-term overall and cancer-specifi c survival using the Kaplan -Meier method were analysed. RESULTS• In all patients, precise removal of tumour thrombus was accomplished in a bloodless fi eld during DHCA.• The mean ( SD ) duration of circulatory arrest was 16 (6) min at a mean hypothermia of 20 (3) ° C. In-hospital mortality was 9.5% (two patients).• The median survival (including in-hospital mortality) was 25 months.• In Kaplan -Meier analysis, 2-and 5-year overall cumulative survival rate was 57 (95% confi dence interval, CI 36 -78)% and 37 (95% CI 15 -58)%, respectively.• Cancer-specifi c cumulative survival was 68 (95% CI 49 -89)% at 2 years and 51 (95% CI 28 -74)% at 5 years. CONCLUSIONS• Late outcome after radical surgical treatment in patients with RCC and TTE reaching up to the right atrium justifi es this extensive procedure.• Cardiopulmonary bypass with DHCA allows safe and precise extirpation of all intracaval and intracardiac tumour mass.

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Section: Discussionsupporting

confidence: 54%

Long‐term survival after radical surgery for renal cell carcinoma with tumour thrombus extension into the right atrium

Dominik¹,

Morávek²,

Žáček³

et al. 2012

BJU International

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“…Tumor extension with vena cava thrombosis is a relatively frequent complication of renal carcinoma, but only exceptionally reaches the right atrium. It is also exceptional that this was a chance finding in an asymptomatic patient [1] .…”

Section: Introductionmentioning

confidence: 99%

Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass

Chaud¹,

Tucci²,

Bassetto³

et al. 2019

Braz J Cardiovasc Surg

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IntroductionAdrenocortical and renal cell carcinomas rarely invade the right atrium (RA). These neoplasms need surgical treatment, are very aggressive and have poor prognostic and surgical outcomes.Case seriesWe present a retrospective cohort of nine cases of RA invasion through the inferior vena cava (four adrenocortical carcinomas and five renal cell carcinomas). Over 13 years (2002-2014), nine patients were operated in collaboration with the team of urologists. Surgery was possible in all patients with different degrees of technical difficulty. All patients were operated considering the imaging examinations with the aid of CPB. In all reported cases (renal or suprarenal), the decision to use CPB with deep hypothermic circulatory arrest (DHCA) on surgical strategy was decided by the team of urological and cardiac surgeons.ConclusionData retrospectively collected from patients of public hospitals reaffirm: 1) Low incidence with small published series; 2) The selected cases did not represent the whole historical casuistry of the hospital, since they were selected after the adoption of electronic documentation; 3) Demographic data and references reported in the literature were presented as tables to avoid wordiness; 4) The series highlights the propensity to invade the venous system; 5) Possible surgical treatment with the aid of CPB in collaboration with the urology team; 6) CPB with DHCA is a safe and reliable option; 7) Poor prognosis with disappointing late results, even considering the adverse effects of CPB on cancer prognosis are expected but not confirmed.

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