Multiple pulmonary emboli as a result of renal cell carcinoma: A case report

Li, Bing; Zeng, Hong; Ding, Mei; Yang, Ping; He, Yuquan

doi:10.3892/ol.2016.5398

Cited by 9 publications

(10 citation statements)

References 15 publications

(10 reference statements)

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“…[7] Renal cell carcinomas may be presented with pulmonary embolism which is associated with end-organ metastasis and poor survival. [8] In conclusion, synchronous pulmonary artery endarterectomy and inferior vena cava thrombectomy can be performed under cardiopulmonary bypass safely with satisfactory results. Complete removal of the pulmonary tumor embolus via pulmonary thromboembolism can provide future benefit in the limited survival related to tumor dissemination.…”

Section: Discussionmentioning

confidence: 80%

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Surgical treatment of massive pulmonary thromboembolism due to renal cell carcinoma

Erol¹,

Ak²,

Öztürk³

et al. 2022

Turk Gogus Kalp Dama

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While renal cell carcinomas frequently invade the renal vein and inferior vena cava, the right atrial extension or formation of bilateral pulmonary massive embolism is quite unusual. A 65-year-old male patient underwent bilateral pulmonary tumor endarterectomy and total thrombectomy of the inferior vena cava combined with left nephrectomy under total circulatory arrest with antegrade cerebral perfusion. Both mediastinal and abdominal approaches facilitated the complete removal of the caval thrombus under the guidance of transesophageal echocardiography. The patient is still under follow-up for six months without metastasis. In conclusion, pulmonary thromboembolism due to renal cell carcinoma is rare, surgical treatment is possible.

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Section: Discussionmentioning

confidence: 80%

“…[ 7 ] Renal cell carcinomas may be presented with pulmonary embolism which is associated with end-organ metastasis and poor survival. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of massive pulmonary thromboembolism due to renal cell carcinoma

Erol¹,

Ak²,

Öztürk³

et al. 2022

Turk Gogus Kalp Dama

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“…However, because some patients have PE before or after surgery and are not eligible for surgery, conservative treatment was still adopted for these patients in our diagnosis and treatment strategy. In this article, 4 patients receiving conservative treatment survived, and their average follow‐up time was 21.3

\pm

11.1 7–31 months. The follow‐up time was short and longer follow‐up is still needed for long‐term outcomes.…”

Section: Discussionmentioning

confidence: 93%

“…7 In addition, stasis or turbulent flow past the thrombus could lead to the deposition of bland thrombus on the vena cava thrombus. 6 Although the effect of anticoagulant drugs on tumor thrombus embolism is negative, tiny In addition, we reviewed 16 related literature [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] 4.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment strategies for intraoperative pulmonary embolism caused by renal tumor thrombus shedding

Chen

Liu

et al. 2022

Journal of Cardiac Surgery

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Aim To provide an overview of techniques for prevention, immediate diagnosis, and treatment strategies of intraoperative pulmonary embolism caused by renal tumor thrombus shedding. Methods A total of 290 patients admitted into our medical center from March 2015 to May 2021 were retrospectively analyzed. All patients underwent radical nephrectomy with tumor thrombectomy. Six patients were diagnosed as pulmonary embolism during the perioperative period, of which two patients had tumor thrombus shedding. One patient underwent thoracotomy and thrombectomy, one patient underwent interventional thrombectomy, and four patients underwent conservative treatment. All patients have gone through our diagnosis and strategy flow chart. Demographic data, tumor characteristics, tumor thrombus characteristics, and follow‐up data were collected. Results In the preoperative risk factor assessment, of the 253 patients who entered the follow‐up, 163 were women, 48 were older than 60 years old, and 83 had a duration of more than 2 months. In addition, 27 patients had tumor thrombus with bland thrombus, and 43 patients had floating tumor thrombus. 78 patients underwent postoperative anticoagulation after evaluation. The average follow‐up time was 23.3 ± $\pm $ 8.6 months (range, 7–31 months). All patients were alive during the follow‐up period. Conclusion For acute pulmonary embolism during nephrectomy and tumor thrombectomy, management strategies can be used to deal with intraoperative emergencies and provide reference.

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“…Thirdly, the major cause of PE is lower limb deep vein thrombus. According to previous reports, approximate 70% of pulmonary emboli occur as a result of lower limb deep vein thrombosis [7][8][9] . On the other hand, abdominal lesions, such as RCC, could be the cause of PE.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of electrocardiographic changes in accurate and urgent diagnosis of pulmonary embolism due to renal cell carcinoma

Kawano

Kato

Kïtamura

2018

Health evaluation and promotion

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Pulmonary embolism (PE) is a clinical entity with a high mortality rate and hence requires accurate, urgent diagnosis and emergency therapy. We report a case of successful treatment of PE in a patient with renal cell carcinoma (RCC) with tumor thrombosis of the renal vein and the inferior vena cava (IVC). PE was diagnosed using electrocardiography (ECG), echocardiography, D-dimer level elevation and contrast-enhanced computed tomography. First, ECG showed a new sinus tachycardia and T wave flattening in the inferior leads (II, III, aVf) in contrast to routine ECG performed previously at a medical health checkup. Second, echocardiography revealed a dilated right ventricle, tricuspid regurgitation, and elevation of systolic pulmonary artery pressure. We emergently inserted a temporary IVC filter at the proximal end of the tumor thrombus under serial echocardiographic evaluation, followed by thrombolytic therapy and anticoagulation therapy. After 3 days, we performed radical nephrectomy and thrombectomy of the IVC. After surgery, the temporary IVC filter was removed, and the anticoagulation therapy was continued. The patient remained symptom free 3 years after surgery. For the diagnosis of PE, it is important to compare the previous ECG obtained on routine medical health checkup and the ECG results at diagnosis. In conclusion, during a medical health checkup in clinical practice, despite its rare occurrence, a life-threatening PE should be ruled out in a patient with risk factors, symptoms, and ECG findings such as tachycardia and ST-T change in the inferior leads and patients with such findings should be urgently referred to a cardiovascular specialist.

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Multiple pulmonary emboli as a result of renal cell carcinoma: A case report

Cited by 9 publications

References 15 publications

Surgical treatment of massive pulmonary thromboembolism due to renal cell carcinoma

Surgical treatment of massive pulmonary thromboembolism due to renal cell carcinoma

Diagnosis and treatment strategies for intraoperative pulmonary embolism caused by renal tumor thrombus shedding

Usefulness of electrocardiographic changes in accurate and urgent diagnosis of pulmonary embolism due to renal cell carcinoma

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