scholarly journals Role of presurgical targeted molecular therapy in renal cell carcinoma with an inferior vena cava tumor thrombus

2018 ◽  
Vol Volume 11 ◽  
pp. 1997-2005 ◽  
Author(s):  
Cheng Peng ◽  
Liangyou Gu ◽  
Lei Wang ◽  
Qingbo Huang ◽  
Baojun Wang ◽  
...  
2018 ◽  
Vol 34 (5) ◽  
pp. 375-382
Author(s):  
Viyana Hamblen

Inferior vena cava (IVC) tumor thrombus in renal cell carcinoma is a rare entity that suggests heightened biologic behavior and a surgical challenge during the course of treatment. Tumor thrombus can extend from the renal vein to the right atrium. This cephalad extension is classified by four different levels. These levels determine which surgical approach is used, whether a thoracoabdominal incision is needed, and whether a patient needs to be placed in circulatory arrest. Complete surgical resection of the tumor is potentially the only curative treatment, although it supposes a challenge because of operative difficulty and the potential for massive bleeding or tumor pulmonary thromboembolism. IVC tumor thrombus presents with a few differentials that need to be assessed, including bland thrombus, primary IVC leiomyosarcoma, hepatocellular carcinoma, adrenal cortical carcinoma, primary lung carcinoma, and Wilms tumor. The importance of diagnosing IVC tumor thrombus secondary to renal cell carcinoma is demonstrated as well as a sonographic protocol for assessing IVC tumor thrombus.


2019 ◽  
Vol 12 (4) ◽  
pp. e227030 ◽  
Author(s):  
Joel Berends ◽  
Eric Gourley ◽  
Dharam Kaushik

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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