Metastatic renal cell carcinoma complicated by right atrial thrombus

Jeelani, Hafiz Muhammad; Sheikh, Muhammad Mubbashir; Riaz, Adeel; Jain, Nikita; Tahir, Nayha; Ehsan, Hamid; Vemireddy, Lalitha Padmanabha

doi:10.1002/ccr3.4028

Cited by 2 publications

(3 citation statements)

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“…Tumor thrombi that invade the vena cava classically present with symptoms of lumbar pain, abdominal mass, hematuria, and anemia, among others. 2 , 3 In these cases, the only curative treatment is surgery by total resection of the tumor and complete removal of the thrombus.…”

Section: Discussionmentioning

confidence: 99%

“… 1 In 4-10% of patients, RCC grows intraluminal towards the renal venous system, in a cranial direction, producing a tumoral venous thrombosis that reaches the right atrium in 1% of cases. 1 , 2 Other abdominal tumors can be associated with IVC tumor thrombosis, such as adrenal carcinoma, leiomyosarcoma of the cava, paratesticular rhabdomyosarcoma, hepatocarcinoma, pheochromocytoma, and Willms tumor. 3 The diagnosis of this complication is made by ultrasound or incidental finding in the preoperative CT scan.…”

Section: Introductionmentioning

confidence: 99%

“…4 Between 45-70% of patients can benefit from tumor thrombus resection surgery and nephrectomy. 2 The greater the extension of the thrombus the worsen surgical morbidity and mortality: when the thrombus exceeds the possibility of clamping the inferior vena cava (IVC) at its infrahepatic limit, clamping of the intrahepatic cava and the hepatic pedicle, and veno-venous bypass or the use of extracorporeal circulation (ECC) is required. 3 This approach has been used for patients with other types of tumors with thrombus in the inferior vena cava (IVC).…”

Section: Introductionmentioning

confidence: 99%

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Surgical management of tumor thrombus into the right atrium

Acuña

Casais

Lugo

et al. 2023

J Cardiovasc Thorac Res

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Renal cell carcinoma represents 3% of solid tumors. In 4-10% of patients, venous tumor thrombosis is present, and 1% reaches the right atrium. Other tumors can be associated with tumor thrombosis. The natural history of venous tumor thrombosis implies a mean survival of 5 months. Between 2001 and 2021, 4 patients underwent resection of tumor thrombi into the right atrium, requiring cardiopulmonary bypass. None of the patients died within 30 days postoperatively. Mean follow-up time was 30.9 months (2.4- 96.1). Two patients are still alive and two died due to disease progression. Died patient’s follow-up was 7.5 and 17.4 months, surpassing life expectancy of those without surgery. We present a series of patients who underwent lumpectomy and IVC thrombectomy. IVC tumor thrombosis has an ominous prognosis, however surgical treatment has an important role by improving the survival of these patients. The multidisciplinary approach is necessary to obtain good postoperative results.

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Section: Discussionmentioning

confidence: 99%