Surgical treatment for transvenous tumor extension into the heart: Four cases

Abstract

From 1984 to 1996, four patients with transvenous intracardiac tumor extension underwent operations in the Kobe University Hospital. The primary tumors of two were intravenous leiomyomatoses originating from the uterus; a third patient had invasive thymoma, and the fourth patient had clear cell sarcoma of the kidney. In 1985, one patient had a curative, staged resection. One-stage operations were carried out in three patients, and all intracardiac tumors were successfully resected en bloc with the primary tumors under conditions of electrical ventricular fibrillation and mild hypothermia. Combined venous reconstructions were necessary for en bloc resection in three cases. Two patients with malignancy received postoperative chemoradiotherapy, and all four patients were discharged uneventfully from our hospital. We consider radical resection with curative intent only for patients with tumors extending into the heart. In these cases, a one-stage operation is preferable, and electrical ventricular fibrillation with mild hypothermia is a recommended method of circulatory assist because of its simplicity.

Clear cell sarcoma of the kidney with cavo-atrial tumor thrombus: complete resection in a child

“…Methods include tumor balloon thrombectomy, excision via atriotomy, IVC resection with or without graft replacement, and resection under vascular isolation or cardiopulmonary bypass [2][3][4][7][8][9]. Case reports also describe similar techniques used in the resection of CCSK with cardiac tumor extension in adults [5,6]. Clear cell sarcoma of the kidney with cavo-atrial tumor thrombus This is the first report in the English language medical literature [10] of complete resection of CCSK with cavoatrial tumor thrombus in a child.…”

Renal Adenocarcinoma with Intramyopericardial and Right Atrial Metastasis, Latter via Coronary Sinus: Report of a Case

“…To establish a histopathological diagnosis of the cardiac masses, an open chest surgical approach was ruled out because of poor general condition of the patient.Possibility of transcatheter biopsy of the tumor mass through the coronary sinus was also ruled out because of risk of embolization, given the fact that the right atrial masses were extremely mobile. Clinically, the general condition of the patient began to deteriorate though she was free from cardiac symptoms unlike in the cases reported by others 1–8 …”

“…Clinically, the general condition of the patient began to deteriorate though she was free from cardiac symptoms unlike in the cases reported by others. [1][2][3][4][5][6][7][8] Repeat CT scanning of the thorax 5 months after the first one showed multiple pulmonary metastases that were larger in size than the previous one. At the time of writing this report, the patient is being treated with chemotherapy at the palliative ward.…”

Strategy for management of retroperitoneal tumors with caval tumor thrombus

“…In patient 4, histology revealed CCSK. Although previously reported in adults [10][11][12], intravascular extension with CCSK is rare [13], comprising only 2% of cases of tumor thrombus in the NWTS-4 [14]. However, the incidence of tumor thrombus among all cases of CCSK (6%) is similar to the incidence in Wilms' tumor (3-8%) [2,4].…”