PO-102 Bleeding management challenges in rare cancer-associated thrombosis: a case report of inferior vena cava thrombus in a patient with testicular germ cell tumour

Germ cell tumours (GCT) are the most common testicular neoplasms, seen mainly in young adults. Rarely they can affect extragonadal tissues, either as primary tumours or as metastases, most commonly to retroperitoneal lymph nodes. A ‘burned-out’ testicular tumour is a metastatic GCT with a relatively occult primary testicular tumour, which has histologically spontaneously regressed. We report a case of a 26-year-old man who presented with an acute history of lower back pain and leg swelling. CT demonstrated a large retroperitoneal soft tissue mass causing right-sided hydronephrosis with inferior vena cava and iliofemoral vein thrombosis. Although clinical examination of the testis was normal, ultrasound imaging of the scrotum identified a burned-out testicular primary. Orchiectomy confirmed the diagnosis and the patient responded well to chemotherapy, with no viable residual tumour on follow-up imaging. However, despite nephrostomy insertion, a dimercaptosuccinic acid (DMSA) scan demonstrated loss of function of the right kidney after treatment.

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A case report of bicaval stents and inferior vena cava valve implantation to control carcinoid symptoms in order to safely allow surgical valve replacement

Endocrine Abstracts ◽

10.1530/endoabs.46.p33 ◽

2016 ◽

Author(s):

Vandana Sagar ◽

Rick Steeds ◽

Sagar Doshi ◽

Shishir Shetty ◽

Tahir Shah

Keyword(s):

Case Report ◽

Inferior Vena Cava ◽

Valve Replacement ◽

Inferior Vena ◽

Vena Cava ◽

Valve Implantation ◽

Surgical Valve Replacement

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Use of superior mesenteric vein for renal transplantation in extensive inferior vena cava thrombosis; a case report

10.26226/morressier.5a38ffa3d462b8029238b69d ◽

2018 ◽

Author(s):

Nalaka Gunawansa

Keyword(s):

Case Report ◽

Renal Transplantation ◽

Inferior Vena Cava ◽

Superior Mesenteric Vein ◽

Inferior Vena ◽

Vena Cava ◽

Mesenteric Vein ◽

Vena Cava Thrombosis ◽

Inferior Vena Cava Thrombosis

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Massive thrombosis after placement of the inferior vena cava filter. Case report

Studies in the Economic History of Southern Africa ◽

10.22201/fm.24484865e.2019.62.1.03 ◽

2019 ◽

Vol 62 (1) ◽

pp. 19-22

Author(s):

José Eduardo Telich-Tarriba ◽

◽

Rodrigo Bolaños-Jiménez ◽

Jorge Arizmendi-Vargas ◽

Alejandra Martínez-Schulted ◽

...

Keyword(s):

Case Report ◽

Inferior Vena Cava ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Vena Cava ◽

Vena Cava Filter

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Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

Journal of Endovascular Therapy ◽

10.1177/15266028211025024 ◽

2021 ◽

pp. 152660282110250

Author(s):

Yun Chul Park ◽

Hyoung Ook Kim ◽

Nam Yeol Yim ◽

Byung Chan Lee ◽

Chan Park ◽

...

Keyword(s):

Case Report ◽

Inferior Vena Cava ◽

Stent Graft ◽

Inferior Vena ◽

Vena Cava ◽

Endovascular Management ◽

Top Down ◽

Life Threatening ◽

The Right ◽

Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

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