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Case Reports
. 2020 Mar;99(11):e19392.
doi: 10.1097/MD.0000000000019392.

Radical nephrectomy combined with removal of tumor thrombus from inferior vena cava under real-time monitoring with transesophageal echocardiography: A case report

Yaozhu Wang  1 , Xu Wang  2 , Yuan Chang  2
Affiliations
Case Reports

Radical nephrectomy combined with removal of tumor thrombus from inferior vena cava under real-time monitoring with transesophageal echocardiography: A case report

Yaozhu Wang et al. Medicine (Baltimore). 2020 Mar.

Abstract

Rationale: Renal carcinoma is a common malignant tumor of the urinary system, 4%-10% of which are complicated with tumor thrombi in the renal vein and the inferior vena cava; in about 1% of patients, the inferior vena cava tumor thrombus invades the right atrium. Surgery is the treatment of choice. Real-time monitoring with transesophageal echocardiography (TEE) has been widely used in various operations, including cardiac and non-cardiac operations for congenital heart diseases, coronary diseases, vascular heart diseases, and aorta diseases, etc. In this article, a case of a patient with right renal carcinoma complicated with an inferior vena cava tumor thrombus is reported.

Patient concerns: A 52-year-old man who was admitted to our hospital for lumbar pain lasting for one month.

Diagnosis: Right renal carcinoma complicated with an inferior vena cava tumor thrombus.

Interventions: Radical nephrectomy of the renal carcinoma and removal of an inferior vena cava tumor thrombus under real-time monitoring with TEE were performed.

Outcomes: Radical nephrectomy was successfully performed within 5 minutes after the inferior vena cava was clamped, and then the inferior vena cava tumor thrombus was removed. On the second day after the operation, the patient's conditions improved; his consciousness was clear; he was transferred to a general ward. On the third day after the operation, the patient was able to get out of bed and was discharged on the sixth day after the operation.

Lessons: Real-time monitoring with TEE played an important role in many aspects in the radical nephrectomy of the renal carcinoma and removal of the inferior vena cava tumor thrombus.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
(A) TEE of tumor thrombus. (B) TEE of tumor thrombus. TEE = transesophageal echocardiography.
Figure 2
Figure 2
TEE of clamping of the inferior vena cava. TEE = transesophageal echocardiography.
Figure 3
Figure 3
(A) TEE after the tumor thrombus was removed. (B) TEE after the tumor thrombus was removed. TEE = transesophageal echocardiography.
See this image and copyright information in PMC

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References

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