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Case Reports
. 2020 Dec 29:35:101551.
doi: 10.1016/j.eucr.2020.101551. eCollection 2021 Mar.

Renal cell carcinoma with tumor thrombus in the lower cava vein reaching the right atrium - Case report and brief review of the literature

Cyro Rezende Laghi  1 , Bruno Costa do Prado  1 , Germano de Freitas Dan  1 , Gustavo Ruschi Bechara  1 , Bruna Afonso Venturini  1 , Claudio Ferreira Borges  1
Affiliations
Case Reports

Renal cell carcinoma with tumor thrombus in the lower cava vein reaching the right atrium - Case report and brief review of the literature

Cyro Rezende Laghi et al. Urol Case Rep. .

Abstract

Approximately 15% of cases of renal cell carcinoma (RCC) can invade the inferior vena cava, leading to the formation of a thrombus inside it, which can reach the cardiac chambers in up to 1% of cases. This article reports a case of RCC with venous thrombus that reached the right atrium. The patient underwent radical nephrectomy with lymphadenectomy and tumor thrombectomy with extracorporeal circulation associated with hypothermia, without total cardiac arrest. The surgical success of this case highlights the need to study new techniques that represent better operative approaches for solid kidney injuries.

Keywords: Caval thrombectomy; Hypothermic circulatory; Renal cell carcinoma; Right atrium thrombus.

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Figures

Fig. 1
Fig. 1
A) Axial section of abdominal CT. B) Coronal section of abdominal CT. C) Surgical access. D) Intra-operative strategy: 1 = Right Kidney; 2 = right renal vein with intraluminal thrombus; 3 = exposure of the inferior vena cava with the presence of a thrombus; 4 = preserved left renal vein; 5 = Pringle maneuver; 6 = batting liver.
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