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. 2014:2014:713049.
doi: 10.1155/2014/713049. Epub 2014 Dec 21.

Radical resection of a late-relapsed testicular germ cell tumour: hepatectomy, cavotomy, and thrombectomy

C Ní Leidhin  1 , C E Redmond  1 , A M Cahalane  1 , H M Heneghan  1 , R Motyer  1 , E R Ryan  1 , E Hoti  1
Affiliations

Radical resection of a late-relapsed testicular germ cell tumour: hepatectomy, cavotomy, and thrombectomy

C Ní Leidhin et al. Case Rep Surg. 2014.

Abstract

Up to 3.2% of patients with testicular germ cell tumours represent with late-relapsing disease. Aggressive surgical resection confers the greatest chance of cure in this patient group. We present the case of a late and extensively relapsed nonseminomatous germ cell tumour with thrombus present along the entire length of the inferior vena cava, as well as in the right hepatic vein. Techniques practised in liver transplantation were used to achieve complete resection of the tumour thrombus. This case illustrates the enhanced potential for tumour resection through a fusion of principles derived from surgical oncology and liver transplantation.

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Figures

Figure 1
Figure 1
Reformatted coronal CT image demonstrating contiguous tumour thrombus in the inferior vena cava extending to the junction of the right atrium.
Figure 2
Figure 2
Reformatted coronal CT image demonstrating tumour thrombus in the inferior vena cava, extending into the right hepatic vein.
Figure 3
Figure 3
Schematic illustration demonstrating (a) IVC exposure and the extent of the tumour thrombus prior to resection. (b) Retrohepatic VC exposure via a right hepatectomy. (c) Infrarenal VC occlusion, enabling cavotomy and thrombus extraction. (d) Suprarenal VC occlusion, enabling cavotomy and thrombus extraction.
See this image and copyright information in PMC

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