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Published on: September 28, 2009
Synchronous nephrectomy and cavoatrial tumor thrombectomy under normothermic extracorporeal circulation and beating
Eleftheria Mavrigiannaki1,2, Ioannis Fesatidis3, Evgenia Kalogridaki2
1Department of Pediatric Surgery General Children's Hospital 'Agia Sofia', Athens, Greece.
Abstract:
Formation of tumor thrombus is an occasional manifestation of renal cell carcinoma (RCC). Intravascular invasion of the renal vein and thereafter the inferior vena cava (IVC) might in very rare cases extend into the cardiac chambers. The subtle course and symptoms of such cases alongside with the engagement of vital anatomical structures marks them as a diagnostic and therapeutic challenge. Aggressive surgical intervention has proven to be critical for survival rates in such cases; however total synchronous resection remains a challenge for the surgical team and a debate for the medical community. Following we report the case of a 66-year-old male who was diagnosed with a RCC of the right kidney accompanied by a tumor thrombus extending into the right atrium, after he suffered a presyncope episode. The patient underwent a radical en bloc nephrectomy and tumor thrombectomy under extracorporeal circulation with beating heart.
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