Robotic level II inferior vena cava thrombectomy for metastatic melanoma

Abstract

We report on a case of a 38-year-old female who presented with metastatic malignant melanoma of her right kidney with Level II tumor thrombus. This is the first ever presented case of a renal melanoma IVC tumor thrombus. Furthermore, in an effort to expand the surgical scope of minimally invasive and robotic surgery, we report management of this lesion as the first case of non-renal cell carcinoma IVC tumor thrombus treated with a robotic thrombectomy.

IVC thrombectomy and atrial tumor removal with radical nephrectomy and adrenalectomy for metastatic melanoma with immune checkpoint inhibitor therapy: A case report and literature review

“…A prior report by Watson et al described a 38-year-old female with Level II thrombus due to metastatic melanoma who underwent caval thrombectomy with radical nephrectomy but was subsequently placed on comfort measures several months after surgery. 3 Of note, this patient presented with brain metastases before surgery, which differs from our case. Klatte et al described a case of a 34-year-old male where open surgical management was performed to treat his secondary melanoma to the kidney with caval thrombus.…”

“… 4 Similarly, this patient presented with brain metastases before nephrectomy, which is unlike our case and may have led to the dismal outcome observed. 3 , 4 There appears to be an association between the development of brain metastases with caval thrombus, suggesting a possible mechanism of hematogenous seeding. 3 , 4 …”

“… 3 , 4 There appears to be an association between the development of brain metastases with caval thrombus, suggesting a possible mechanism of hematogenous seeding. 3 , 4 …”

“… 2 Few reports have described this condition, with none describing surgical intervention or postoperative course. 1 , 3 , 4 Here, we present a patient with metastatic melanoma with Level IV tumor thrombus extension into the right atrium and discuss the benefits of metastasectomy in the era of immunotherapy for patients with this unusual presentation.…”

Internal Thoracic Vein Tumor Thrombus From Sternal Melanoma Metastasis on 18F-FDG PET/CT

“…2,3 18 F-FDG PET/CT plays a pivotal role in the staging of high-risk melanoma patients and in the assessment of therapy response. [4][5][6][7][8][9][10] Melanoma has the potential for metastases to all body parts, [11][12][13][14][15][16][17][18] including a direct invasion of veins, and melanoma metastasis forming a tumor thrombus has been sporadically described in the literature, mainly arising from visceral organ metastases, such as from the kidney, 19,20 pancreas, liver, 21,22 and small bowel. 23 There is also one report of an inguinal lymph node metastasis with femoral vein invasion, 24 but to the best of our knowledge, this is the first documented case of tumor thrombus in the internal thoracic intern vein from a bone metastasis of malignant melanoma.…”