Intraluminal Tumour Thrombus of a Mixed Non-Seminomatous Germ Cell Tumour of Testis within the Inferior Vena Cava

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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Radical Resection of a Late-Relapsed Testicular Germ Cell Tumour: Hepatectomy, Cavotomy, and Thrombectomy

Case Reports in Surgery ◽

10.1155/2014/713049 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

C. Ní Leidhin ◽

C. E. Redmond ◽

A. M. Cahalane ◽

H. M. Heneghan ◽

R. Motyer ◽

...

Keyword(s):

Liver Transplantation ◽

Germ Cell ◽

Germ Cell Tumour ◽

Vena Cava ◽

Radical Resection ◽

Cell Tumour ◽

Tumour Resection ◽

Testicular Germ Cell Tumour ◽

Testicular Germ Cell ◽

Tumour Thrombus

Up to 3.2% of patients with testicular germ cell tumours represent with late-relapsing disease. Aggressive surgical resection confers the greatest chance of cure in this patient group. We present the case of a late and extensively relapsed nonseminomatous germ cell tumour with thrombus present along the entire length of the inferior vena cava, as well as in the right hepatic vein. Techniques practised in liver transplantation were used to achieve complete resection of the tumour thrombus. This case illustrates the enhanced potential for tumour resection through a fusion of principles derived from surgical oncology and liver transplantation.

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Robust response to nivolumab in patient with renal cell carcinoma inferior vena cava tumour thrombus

BMJ Case Reports ◽

10.1136/bcr-2018-227030 ◽

2019 ◽

Vol 12 (4) ◽

pp. e227030 ◽

Cited By ~ 3

Author(s):

Joel Berends ◽

Eric Gourley ◽

Dharam Kaushik

Keyword(s):

Renal Cell Carcinoma ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Inferior Vena ◽

Vena Cava ◽

Distant Metastases ◽

Molecular Therapy ◽

Tumour Thrombus ◽

Robust Response

A 47-year-old previously healthy man presented with acute moderate flank pain. Evaluation revealed left renal cell carcinoma, with inferior vena cava tumour thrombus invasion. Patient had no significant history or risk factors to pre-dispose him to genitourinary cancers. Surgery was deemed to not be appropriate due to distant metastases, but patient received targeted molecular therapy and immunotherapy with striking regression of the thrombus.

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