[Caval extension of renal cancer. Surgical problems]

The authors report on a case of renal neoplasm with associated thrombosis of the vena cava extending to the right auricle. The authors undertook, right away, by way of a median sternotomy and under extracorporeal circulation, the ablation of the intra-cardiac thrombus, and also the removal of the remainder of thrombus in the inferior vena cava. This having been achieved without complications, they performed excision of the right kidney as well as a cavectomy, thus effecting ablation of the tumour while preserving the venous drainage above the liver and the left renal vein. A review of the literature confirms that exeresis of this type of tumour is logical in the absence of metastasis or lymphatic invasion. They stress, above all, the importance of firstly effecting exeresis of the intra-cardiac thrombus under the facility of extracorporeal circulation. This ensures the least risk to the patient, for surgery of this kind.