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. 2018 Nov;13(2):181-184.
doi: 10.2185/jrm.2976. Epub 2018 Nov 29.

Preoperative inferior vena cava filter implantation to prevent pulmonary fat embolism in a patient showing renal angiomyolipoma extension into the renal vein: A case report and literature review

Motohiro Fujiwara  1 , Naoko Kawamura  1 , Tetsuo Okuno  1
Affiliations

Preoperative inferior vena cava filter implantation to prevent pulmonary fat embolism in a patient showing renal angiomyolipoma extension into the renal vein: A case report and literature review

Motohiro Fujiwara et al. J Rural Med. 2018 Nov.

Abstract

Renal angiomyolipoma without local invasion is usually considered benign entity, however, it may extend into the renal vein or the inferior vena cava. Renal angiomyolipoma with venous extension should be treated; however, surgical complications such as iatrogenic pulmonary fat embolism remain a serious concern. We present a case of a 66-year-old Japanese woman without tuberous sclerosis in whom a right-sided renal tumor was incidentally detected on ultrasonography during a health check-up. Further evaluation showed that the tumor extended into the renal vein, and she was successfully treated using preoperative inferior vena cava filter placement and radical nephrectomy. An inferior vena cava filter can prevent catastrophic pulmonary fat embolism during nephrectomy.

Keywords: IVC filter; angiomyolipoma; tumor thrombus.

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Figures

Figure 1
Figure 1
Coronal and axial contrast-enhanced computed tomography (CT) image shows a fat-density lesion (arrowhead) in the right-sided renal parenchyma extending into the right renal vein.
Figure 2
Figure 2
An inferior vena cava (IVC) filter (arrowhead) is observed above the right renal artery.
Figure 3
Figure 3
Gross examination shows the right kidney and the tumor thrombus protruding into the right renal vein.
See this image and copyright information in PMC

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