Renal Cell Carcinoma With Tumor Thrombus: A Case Series in Puerto Rico

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Renal cell carcinoma (RCC) is a common kidney cancer.
• Intravascular tumor thrombus (TT) in RCC indicates a worse prognosis.
• Limited data exists on RCC TT in Puerto Rico (PR).

Purpose of the Study:

• To describe RCC TT presentation, management, and outcomes in Puerto Rico.
• To emphasize surgical management and outcomes of RCC TT.
• To provide data for clinicians caring for Puerto Rican patients with RCC TT.

Main Methods:

• Retrospective single-center study (2018-2022).
• Evaluated 12 patients with documented RCC TT undergoing nephrectomy.
• Data abstracted from electronic health records; categorized using RCC TT guidelines.

Main Results:

• Most patients lacked TT-specific symptoms; pulmonary embolism was the most severe symptom.
• Common comorbidities included hypertension, high BMI, and type 2 diabetes.
• Laparoscopic radical nephrectomy with TT resection was performed in nearly 75% of cases with zero intraoperative complications.

Conclusions:

• RCC with TT occurs in Puerto Rico and can be managed effectively with laparoscopic surgery.
• No definitive association found between BMI, tumor size, WHO/ISUP grade, and TT extension.
• Laparoscopic removal of RCC TT is safe and effective; further research is needed.