CLINICAL CASE OF SURGERY KIDNEY CANCER WITH TUMOR THROMBUS IN THE ATRIUM AND ISOLATED LIVER METASTASIS

Presents a clinical case of successful surgical treatment of kidney cancer with tumor thrombus of the inferior vena cava (IVC) to the level of the atrium, with simultaneous resection of segment I of the liver containing a single metastasis, in 57-year patient.

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Renal Cancer with Tumor Thrombus of the Inferior Vena Cava and the Right Atrium

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2020-13-3-214-226 ◽

2020 ◽

Vol 13 (3) ◽

pp. 214-226

Author(s):

Yulia Aleksandrovna Stepanova ◽

Aleksandr Anatolevich Gritskevch ◽

Amiran Shotaevich Revishvili ◽

Madina Valerevna Kadirova ◽

Egor Sergeyevich Malyshenko ◽

...

Keyword(s):

Surgical Treatment ◽

Inferior Vena Cava ◽

Kidney Cancer ◽

Right Atrium ◽

Tumor Thrombus ◽

Clinical Case ◽

Inferior Vena ◽

Vena Cava ◽

Radical Treatment ◽

The Right

ntroduction. A distinctive feature of kidney cancer is a frequent, compared with other tumors, spread of the tumor through the venous collectors (in the renal and inferior vena cava up to the right atrium), along the path of least resistance to invasive growth.The aim of the study was to present a clinical case of radical treatment of kidney cancer involving extensive IVC thrombosis.Materials and methods. The study describes a clinical case of radical treatment of patient M. with kidney cancer involving extensive IVC thrombosis, extending to the right atrium (written informed consent for patient information and images to be published was obtained prior to the study). During preoperative examination, the patient was diagnosed with renal cell carcinoma with non-occlusive hypervascular tumor thrombus of the renal vein, the inferior vena cava and the right atrium based on the findings of ultrasound examination (transabdominal and transthoracic, and transesophageal), multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).Results and discussion. Surgical treatment remains the main method of treatment of renal cell cancer, moreover, the inferior vena cava thrombosis cannot serve as a cause for refusing surgical treatment. The thrombus spreading along the venous collectors is an important factor in determining the tactics of surgical treatment. The length of the tumor thrombus, as well as the degree of its fixation and ingrowth into the vein wall is of great significance for planning surgical techniques and predicting clinical outcomes. Based on various methods of radiological examination, patient M. was diagnosed with cancer of the right kidney, 3 stage T3cNxM0, IVC tumor thrombus, paraneoplastic syndrome (hyperthermia), right-sided nephrectomy with aortocaval lymphadenectomy, thrombectomy from the IVC, vascular isolation of the liver, resection of the IVC, thrombectomy from the right atrium combined with cardiopulmonary bypass.Conclusion. Despite the technical complexity of nephrectomy with thrombectomy from the IVC, especially in the presence of a massive supradiaphragmatic thrombus, these interventions have no alternatives if a radical treatment is to be achieved. Step-by-step support using radiological methods of investigation is an important aspect of patients preparation; this allowing determining the exact volume of the damage and non-invasively assessing clinical outcomes of surgical treatment.

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Nephrectomy with resection of the retrohepatic part of the inferior vena cava in a patient with kidney cancer and tumor thrombosis of the inferior vena cava

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2021-180-2-83-86 ◽

2021 ◽

Vol 180 (2) ◽

pp. 83-86

Author(s):

A. I. Babich ◽

A. V. Osipov ◽

A. I. Narkevich ◽

A. Е. Demko

Keyword(s):

Surgical Treatment ◽

Inferior Vena Cava ◽

Kidney Cancer ◽

Renal Cancer ◽

Clinical Case ◽

Inferior Vena ◽

Vena Cava ◽

Tumor Thrombosis

A clinical case of surgical treatment of renal cancer with tumor thrombosis of the inferior vena cava is presented. A rare operation was performed – nephrectomy and resection of the retrohepatic part of the inferior vena cava with a thrombus.

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Preliminary Exploration of Tolerability in Preoperative Stereotactic Ablation Radiotherapy Combined with Surgical Treatment for Renal Cell Carcinoma and Inferior Vena Cava Tumor Thrombus

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2019.06.1955 ◽

2019 ◽

Vol 105 (1) ◽

pp. E256

Author(s):

Z. Liu ◽

R. Peng ◽

H. Wang ◽

L. Ma ◽

J. Wang

Keyword(s):

Renal Cell Carcinoma ◽

Surgical Treatment ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Tumor Thrombus ◽

Inferior Vena ◽

Vena Cava

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Surgical treatment of recurrent right kidney cancer complicated by tumoral thrombosis of inferior vena cava and right heart combined with coronary artery disease

Khirurgiya Zhurnal im N I Pirogova ◽

10.17116/hirurgia2016457-58 ◽

2016 ◽

pp. 57

Author(s):

R. N. Komarov ◽

Yu. V. Belov ◽

S. V. Chernyavsky ◽

E. K. Germogenova ◽

P. A. Karavaykin

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Inferior Vena Cava ◽

Kidney Cancer ◽

Inferior Vena ◽

Vena Cava ◽

Right Heart ◽

Artery Disease

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Surgical treatment of kidney cancer with extended inferior vena cava thrombosis: complications and long-term results

Cancer Urology ◽

10.17650/1726-9776-2017-13-1-37-44 ◽

2017 ◽

Vol 13 (1) ◽

pp. 37-44 ◽

Cited By ~ 3

Author(s):

V. A. Atduev ◽

Z. V. Amoev ◽

A. A. Danilov ◽

V. A. Bel’skiy ◽

D. S. Ledyaev ◽

...

Keyword(s):

Surgical Treatment ◽

Inferior Vena Cava ◽

Kidney Cancer ◽

Inferior Vena ◽

Vena Cava ◽

Long Term Results ◽

Vena Cava Thrombosis ◽

Inferior Vena Cava Thrombosis

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Results of surgical treatment of inferior vena cava tumor thrombi in renal cell carcinoma

Perspectives in Surgery ◽

10.33699/pis.2020.99.4.167-171 ◽

2020 ◽

Vol 99 (4) ◽

pp. 167-171

Keyword(s):

Renal Cell Carcinoma ◽

Surgical Treatment ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Kidney Cancer ◽

Renal Cell ◽

Inferior Vena ◽

Vena Cava ◽

Oncological Treatment ◽

Tumour Thrombus

Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncological patients. Tumor thrombus of IVC is characteristic for patients with renal cell carcinoma, occurring in 10−18%. The aim of the work is to analyze of surgical treatment in patients with cancer thrombosis of inferior vena cava in kidney cancer. Methods: Between 2010 and 2019 we treated 32 patients with kidney cancer complicated by thrombotic infiltration of the inferior vena cava. According to Nesbitt classification the levels of thrombotic infiltration of the inferior vena cava were: I–8 (25%), II–14 (43.8%), III–6 (18.8%), and IV–4 (12.5%). Nephrectomy with thrombectomy of the cancer thrombus in the inferior vena cava was performed in all patients. In addition to laparotomy, sternotomy was approached in 4 patients with Nesbitt IV and in 2 patients with Nesbitt III. Results: Primary suture of IVC was performed in 26 patients; angioplasty of IVC was performed in 4 patients; and resection of IVC with replacement using a polytetrafluoroethylene interposition graft was done in 2 patients. Radical surgical treatment was performed in 27 (84.3%) patients, and palliative in 5 (15.6%) patients. In the postoperative period, 1 (3.1%) patient (Nesbitt IV) died of cardiac failure during hospitalisation. Two-year survival was observed in 75% of the cases. Conclusion: Tumorous infiltration of IVC is associated with a high potential for tumour embolisation to the lungs, leading to the formation of multiple metastases and spreading of the underlying disease. Postoperative comfort is improved considerably after nephrectomy of the affected kidney and removal of the tumour thrombus, including IVC resection as appropriate, and when combined with oncological treatment, the survival rate is increased significantly, as well.

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Radiodiagnostic methods in determining the structure of tumor thrombus in the inferior vena cava in kidney cancer

Cancer Urology ◽

10.17650/1726-9776-2015-11-3-40-45 ◽

2015 ◽

Vol 11 (3) ◽

pp. 40

Author(s):

N. B. Vikhrova ◽

B. I. Dolgushin ◽

V. O. Panov ◽

V. B. Matveev ◽

N. L. Shimanovskiy ◽

...

Keyword(s):

Inferior Vena Cava ◽

Kidney Cancer ◽

Tumor Thrombus ◽

Inferior Vena ◽

Vena Cava

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Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2020-7-3-9 ◽

2020 ◽

Vol 7 (3) ◽

pp. 91-98

Author(s):

N. V. Vorobev ◽

F. S. Ashyrova ◽

M. P. Golovashchenko ◽

L. O. Petrov ◽

A. D. Kaprin

Keyword(s):

Renal Cell Carcinoma ◽

Surgical Treatment ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Kidney Cancer ◽

Renal Cell ◽

Inferior Vena ◽

Cell Cancer ◽

Vena Cava ◽

Specific Tumor

Among malignant neoplasms, kidney cancer occupies one of the first places in terms of the growth rate of incidence in Russia. Despite the possibilities of modern diagnostic research methods, the number of patients with common forms of the disease does not decrease. In 5–10% of cases, renal cell carcinoma is complicated by the formation of a tumor clot in the inferior Vena cava (VCI), which requires volume surgery — nephrectomy with thrombectomy, which is the only effective treatment option for this group of patients. Previously, the results of treatment of locally advanced kidney cancer were unsatisfactory due to the high incidence of complications and mortality after extended surgical interventions. However, improving the operation technique requires a re-evaluation of previous representations. Performing a nephrectomy with a VCI thrombectomy is not an easy task and is often associated not only with technical difficulties due to the need for mobilization, control and resection of the inferior Vena cava, but also with the risk of intra — and postoperative complications. The most difficult task is the choice of surgical tactics for descending non-tumor hemorrhagic thrombosis. As a result of long-term tumor obstruction, organized blood clots that are soldered to the intima of the vessel often spread to the common iliac veins and, as a rule, are technically impossible to remove. If the VCI is preserved, a residual hemorrhagic blood clot in the area of its confluence is a potential source of pulmonary embolism (PE), for the prevention of which mechanical plication is used. This maneuver does not lead to the development of clinically significant chronic venous insufficiency of the lower extremities (CVI NC), postoperative VCI or PE thrombosis. Despite the technical complexity of the operation and the difficult course of the postoperative period, surgical treatment of renal cell cancer complicated by tumor thrombosis is certainly justified. This article presents a clinical case of surgical treatment of a patient with renal cell cancer complicated by massive specific (tumor) and non-specific thrombosis in the presence of reduced parenchymalexcretory function of the contralateral kidney and severe cardiac pathology. Goal: to share experience and demonstrate the results of successful surgical treatment of renal cell carcinoma.

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