Renal angiomyolipoma associated with inferior vena caval tumour thrombus

Gotoh, Akinobu; Gohji, Kazuo; Fujisawa, Masato; Okada, Hiroshi; Arakawa, Soichi; Hanioka, Keisuke; Kamidono, Sadao

doi:10.1046/j.1464-410x.1998.00581.x

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…This is the 11th case of this type to be published [1,2]: 2 of these cases had invasion of the right atrium [2] and our case is only the 2nd with angiomyolipoma of the left kidney extending to the vena cava.…”

Section: Discussionmentioning

confidence: 90%

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Angiomyolipoma with a Caval Thrombus

Schips

Ratschek²,

Gallé³

et al. 2003

Urol Int

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We report the case of a female patient presenting with flank pain. Abdominal ultrasound revealed a tumor of 8 cm in diameter. After abdominal computerized tomography, the tumor was classified as angiomyolipoma with a tumor thrombus in the inferior vena cava. After nephrectomy, the diagnosis was confirmed histologically. To our knowledge, this is the 11th case of a renal angiomyolipoma extending into the vena cava.

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Section: Discussionmentioning

confidence: 90%

“…Although the disease is benign, extension to the renal vein, the inferior vena cava or lymph nodes has been reported [1][2][3]. We report a patient with angiomyolipoma and tumor thrombus in the vena cava.…”

Section: Introductionmentioning

confidence: 97%

Angiomyolipoma with a Caval Thrombus

Schips

Ratschek²,

Gallé³

et al. 2003

Urol Int

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“…Renal cell carcinoma is the most common cause, 1 but germ cell tumor, retroperitoneal leiomyosarcoma, adrenal cortical carcinoma, renal angiomyolipoma, and hepatic hemangioma have been reported as other causes. [2][3][4][5][6][7] In this case, a germ cell tumor was associated with IVC thrombosis. Germ cell tumor is the most frequent malignancy in men aged 18-35 years.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC Filter

Natsuaki

Numaguchi

Tada

et al. 2009

Circ J

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A 21-year-old man was admitted to our hospital for acute chest pain and dyspnea. On arrival, his blood pressure was 110/40 mmHg and heart rate was 112 beats/min. In the arterial blood gas analysis, pH was 7.43, PaCO2 was 31 mmHg, and PaO2 was 92 mmHg under 10 L/min oxygen inhalation. In the blood tests, blood cell count and renal functions were normal, but lactate dehydrogenase and C-reactive protein levels were high at 590 IU/L and 3.7 mg/dl, respectively. Of the coagulation values, the d-dimer level was high (13.7 μg/ml), and ATIII activity was slightly low (60%), but the activities of protein C and protein S were normal. Plain chest X-ray showed mild pulmonary artery dilatation. Ultrasonic cardiogram (UCG) showed right ventricle overload and pulmonary hypertension (estimated systolic pulmonary artery pressure 60 mmHg). We suspected pulmonary embolism (PE), and performed contrast computed tomography (CT), which revealed massive thrombi in both pulmonary arteries ( Figure 1A). Bilateral perfusion defects were found on perfusion scintigraphy of the lung ( Figure 1B), and we diagnosed PE. In addition, abdominal CT showed a retroperitoneal tumor approximately 10×5 cm (Figure 2A). The inferior vena cava (IVC) was obstructed by the tumor and thrombus existed in the right common iliac vein. We started thrombolysis (urokinase 240,000 U/day for 5 days) followed by heparinization (48,000 U/day). We controlled the APTT at 60-80 s. Under this therapy, his oxygen saturation and symptoms improved each day and on the 3 rd day, arterial blood gas analysis showed that pH was 7.43, PaCO2 was 40 mmHg, and PaO2 was 88 mmHg under room air. The pulmonary artery pressure had also decreased on UCG (estimated systolic pulmonary artery Japan. E-mail: natsuaki@saiseikai-hp.chuo.fukuoka.jp All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: cj@j-circ.or.jp Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC FilterMasahiro Natsuaki, MD; Kotaro Numaguchi, MD; Hideo Tada, MD*; Yuichiro Nakashima, MD**; Masanori Okabe, MD; Yusuke Yamamoto, MD Pulmonary embolism (PE) is a fatal disease that is very rare in young people. A 21-year-old man developed PE because of a retroperitoneal tumor. The inferior vena cava (IVC) was obstructed by the tumor, and thrombus existed in the right common iliac vein. Thrombolysis and heparinization improved his symptoms prior to urgent tumor resection. A temporary IVC filter was inserted the day before the operation, but 8 h later fatal massive PE occurred. At autopsy, the retroperitoneal tumor was revealed as a metastatic choriocarcinoma. Prophylactic use of a temporary IVC filter might have paradoxically induced recurrence of massive PE in this case. (Circ J 2009; 73: 1756 -1758

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“…Cuando es menor o igual a 4 cm se preconiza observarlos, con seguimiento por imá-genes con una periodicidad que varía según la literatura médica. Sin embargo cuando es mayor de ese tamaño, o en raras ocasiones compromete la vena renal, cava o incluso el corazón se prefiere la cirugía [2][3][4][5][6][7] . En el caso que nos ocupa, aunque el tumor llegaba a la aurícula derecha, la paciente no presentaba síntomas ni signos cardiovasculares.…”

Section: Discussionunclassified

“…Es de naturaleza benigna 1 . Sin embargo, en raras ocasiones puede tener una evolución de curso potencialmente maligno, invadiendo la vena renal, la VCI e incluso la aurícula derecha [2][3][4][5][6][7] . Hay pocos casos reportados con un trombo tumoral intracardíaco.…”

Section: Introductionunclassified

Angiolipoma renal con extensión tumoral a vena cava inferior y aurícula derecha

C²,

O³

et al. 2008

Rev Chil Cir

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RESUMENEl angiomiolipoma renal es un tumor benigno mesenquimático. Constituyen sólo del 2 al 6% de los tumores renales. Existen alrededor de 12 casos reportados con invasión a las venas renales y la cava inferior. En menos de 5, hay extensión de trombo tumoral hasta aurícula derecha. Objetivo: Presentar el caso clínico, manejo y evolución de una paciente con un angiomiolipoma renal con extensión tumoral a vena renal y cava inferior y que compromete la cavidad auricular derecha casi en su totalidad. Paciente y método: 50 años, sexo femenino con hallazgo del tumor por un ultrasonografía abdominal motivada por el estudio de síntomas digestivos de origen probablemente funcional. Se confirma el diagnóstico con TAC y ecocardiograma doppler. Se realiza una cirugía combinada, abdominal y esternotómica, con la ayuda de un by pass aortopulmonar. Resultados: Nefrectomía izquierda, liberación intravascular del tumor que se empuja por cava inferior y se extrae en block por la aurícula derecha. Evoluciona inicialmente en forma satisfactoria, pero desarrolla distress respiratorio con angio TAC de tórax negativo para TEP a las 48 h de la cirugía. Se inicia anticoagulación empírica con HBPM y encontrándose extubada y en buenas condiciones hace un hemoperitoneo el día 14, encontrándose hemorragia en napa en los sitios de disección previa. De alta a los 21 días. El seguimiento alejado a los 2 años revela una hernia incisional, reparada sin incidentes, y sin otras complicaciones ni signos de recidiva de patología original. Conclusión: El manejo de equipo multidisciplinario nos permitió ayudar exitosamente a esta paciente con patología rara y compleja.PALABRAS CLAVE: Angiomiolipoma renal, aurícula derecha. SUMMARYRenal angiomyolipoma is an uncommon benign tumor of mesenchymal origin. In less than five of 12 cases reported with renal vein and inferior vena cava involvement the thrombus extends to the right atrium.

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Renal angiomyolipoma associated with inferior vena caval tumour thrombus

Cited by 11 publications

References 4 publications

Angiomyolipoma with a Caval Thrombus

Angiomyolipoma with a Caval Thrombus

Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC Filter

Angiolipoma renal con extensión tumoral a vena cava inferior y aurícula derecha

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