Renal Cell Carcinoma with Thrombus Extension into the Inferior Vena Cava and the Right Atrium: A Case Report

Abdelfattah, Ahmed; Wazir, Mohamed El; Ali, Yehia Z; Naser, Jwan A.; Wiley, Brandon M.

doi:10.1016/j.case.2020.05.004

Cited by 4 publications

(10 citation statements)

References 9 publications

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“…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%

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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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Section: Discussionmentioning

confidence: 99%

“…In addition, we reviewed 16 related literature 19–34 on Pubmed by keywords of renal tumor thrombus and pulmonary embolism. The total number of patients was 17, age ranging from 35 to 82 years old, with males accounting for 64.7% and females accounting for 35.3%.…”

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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“…The presence of tumor thrombus changes staging, prognosis, and surgical approach, for example, renal vein ligation in case of limited tumor to the renal vein and its tributaries, or a potential thoracotomy and open heart surgery in case of tumor extension above the diaphragm. 1 Furthermore, removal of the thrombus could provide a better quality of life, regardless of therapy outcome (cure/palliation). 2 We present a case of fluorine-18 fluorodeoxyglucose (FDG)-avid spindle cell sarcoma of the right kidney with involvement of the right renal vein and tumor thrombus extending through the inferior vena cava (IVC).…”

Section: Introductionmentioning

confidence: 99%

“… 1 Tumor thrombus has been reported to demonstrate increase in fluorine-18 fluorodeoxyglucose (FDG) uptake that would differentiate it from the benign bland thrombus which would not take up FDG on positron emission tomography/computed tomography (PET/CT) scan. 1 We present a case of spindle cell sarcoma of right kidney whose baseline contrast-enhanced CT revealed a mass replacing the right kidney and right renal vein associated with thrombus in the inferior vena cava (IVC). 18 F-FDG PET/CT imaging was done that revealed an FDG-avid hypermetabolic malignant right renal mass with hypermetabolic IVC thrombus extending to the right atrium.…”

mentioning

confidence: 99%

“…Abstract Tumor thrombus (also called intravascular tumor extension) can be defined as tumor extending into vessel; typically a vein, it occurs in a lot of malignancies like hepatocellular carcinoma, Wilms tumor, and others. 1 Tumor thrombus has been reported to demonstrate increase in fluorine-18 fluorodeoxyglucose (FDG) uptake that would differentiate it from the benign bland thrombus which would not take up FDG on positron emission tomography/computed tomography (PET/CT) scan. 1 We present a case of spindle cell sarcoma of right kidney whose baseline contrast-enhanced CT revealed a mass replacing the right kidney and right renal vein associated with thrombus in the inferior vena cava (IVC).…”

mentioning

confidence: 99%

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Renal Spindle Cell Tumor with Thrombus Extension into the Inferior Vena Cava and the Right Atrium Depicted by PET/CT Scan

et al. 2022

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Tumor thrombus (also called intravascular tumor extension) can be defined as tumor extending into vessel; typically a vein, it occurs in a lot of malignancies like hepatocellular carcinoma, Wilms tumor, and others.1 Tumor thrombus has been reported to demonstrate increase in fluorine-18 fluorodeoxyglucose (FDG) uptake that would differentiate it from the benign bland thrombus which would not take up FDG on positron emission tomography/computed tomography (PET/CT) scan.1 We present a case of spindle cell sarcoma of right kidney whose baseline contrast-enhanced CT revealed a mass replacing the right kidney and right renal vein associated with thrombus in the inferior vena cava (IVC). 18F-FDG PET/CT imaging was done that revealed an FDG-avid hypermetabolic malignant right renal mass with hypermetabolic IVC thrombus extending to the right atrium.

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Surgical treatment of inferior vena cava tumor thrombus.

uulu¹,

Chevina²,

Raguzina³

et al. 2022

ECU

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Introduction. Venous invasion and tumor thrombus formation are rare, but life-threatening complications of renal cell carcinoma (RCC), especially in combination with metastases, are considered significant adverse prognostic factors. Aim. To systematize the existing knowledge and summarize the clinical experience of surgical treatment (open and robot-assisted surgery) of RCC with inferior vena cava (IVC) tumor thrombus. Materials and methods. A literature search in the period 2000-2022 was performed in core databases MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar and Web of Science. The PICO framework (Population-Intervention-Comparison-Outcome) was used to develop a literature search strategy. The following keywords were used to search databases: «renal cell carcinoma», «venous invasion», «inferior vena cava tumor thrombus», «surgical treatment», «robot-assisted», «clinical outcomes». Results. A total of 65 publications were identified. Various classifications of tumor thrombus level are considered, their inferiority and superiority in terms of selecting optimal surgical treatment, both open or robot-assisted surgeries, are discussed. Independent predictors of severe perioperative complications are determined. Optimal surgical treatment of RCC with tumor thrombus is highlighted. Functional and oncological outcomes of patients with RCC with IVC tumor thrombus, who underwent open surgical intervention and robot-assisted ones, are presented. Conclusion. Open surgery in patients with RCC and IVC tumor thrombus above the hepatic veins is associated with prolonged surgery duration, higher intraoperative blood loss, and prolonged in-hospital stay. Prolonged in-hospital stay, the need for blood transfusion, metastasis, sarcomatoid differentiation, and Clavien-Dindo grade 3-5 postoperative complications are predictors of poor outcomes.

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Renal Cell Carcinoma with Thrombus Extension into the Inferior Vena Cava and the Right Atrium: A Case Report

Cited by 4 publications

References 9 publications

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

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

Renal Spindle Cell Tumor with Thrombus Extension into the Inferior Vena Cava and the Right Atrium Depicted by PET/CT Scan

Surgical treatment of inferior vena cava tumor thrombus.

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