Technology: an aid to clinical judgement

Area of Science:

• Cardiovascular Surgery
• Nephrology
• Medical Imaging

Background:

• Renal cell carcinoma (RCC) with tumor thrombus extending supradiaphragmatically often requires cardiopulmonary bypass for complete surgical resection.
• Accurate delineation of tumor thrombus extent is crucial for surgical planning and patient outcomes.

Observation:

• A case is presented involving a patient with renal cell carcinoma and a tumor thrombus that invaded the right ventricle.
• Transesophageal echocardiography (TEE) was utilized to assess the precise extent of the tumor invasion.

Findings:

• The study demonstrates the successful complete removal of a renal cell carcinoma with extensive tumor thrombus.
• Transesophageal echocardiography (TEE) proved instrumental in guiding the surgical team by providing real-time visualization of the tumor's intracardiac extension.

Implications:

• TEE can be a valuable tool in managing complex renal cell carcinoma cases with intracardiac extension, potentially optimizing surgical strategy.
• This approach may improve the safety and efficacy of surgical interventions for advanced renal cell carcinoma with venous tumor thrombus.