scholarly journals A Cardiac Approach to Wilms Tumor with Tumor Thrombus Extension to the Right Atrium Without Cardiopulmonary Bypass: A 5-Year Follow-up

2021 ◽  
Vol 14 (5) ◽  
Author(s):  
Leily Mohajerzadeh ◽  
Zahra Ansari Aval ◽  
Mahmoud Beheshti Monfared ◽  
Shiva Nazari ◽  
Ali Dabbagh ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Wilms Tumor ◽  
Tumor Resection ◽  
Vena Cava ◽  
Large Mass ◽  
Good Prognosis ◽  
The Right ◽  
Cardiac Surgeons

Introduction: Wilms tumor is the most common kidney cancer in children, but Wilms's tumors that extend by direct intravascular spread into the right side of the heart are rare and at this stage, they require the cardiac surgeons’ intervention. Case Presentation: The patient was a 2-year-old girl who was hospitalized due to fever and abdominal pain that had started 2 weeks before admission. Patient’s full abdominal exams revealed a large mass in the right kidney with a thrombus tumor in the entire inferior vena cava which was extended into the right atrium. Patient completed 8 weeks of neoadjuvant chemotherapy. After chemotherapy no changes was noted in renal mass and tumor thrombus. As, the thrombosis in the atrium was loose and there was a high risk of pulmonary embolism, emergency surgery was needed. Two pediatric and cardiac teams, simultaneously performed the surgery without cardiopulmonary bypass and cardiac arrest. Both kidney mass and the thrombus tumor were completely removed. Patient followed up for 5 years after surgery and no surgical complications, tumor recurrence, or metastasis were observed during that period. Conclusions: Although surgical intervention and tumor resection leads to good prognosis, multimodality management and multidisciplinary approach gives the best results.

scholarly journals PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics

2022 ◽  
Vol 11 ◽  
Author(s):  
Zhuo Liu ◽  
Yuxuan Li ◽  
Yu Zhang ◽  
Xun Zhao ◽  
Liyuan Ge ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
Surgical Techniques ◽  
Perioperative Outcomes ◽  
Grading System ◽  
Open Approach ◽  
Peking University ◽  
The Right

PurposeTo explore the different treatment strategies for urinary tumors with Mayo IV thrombus.Materials and MethodsWe retrospectively analyzed the patients with Mayo IV thrombus in Peking University Third Hospital from January 2014 to April 2021. We used the Peking University Third Hospital (PUTH) grading system to classify urinary tumors with supradiaphragmatic thrombus. PUTH-A referred to the filled thrombus whose tip just reached above the diaphragm, or the thrombus entering the right atrium (< 2cm). PUTH-B referred to the filled thrombus entering the right atrium (> 2cm), or the thrombus invading the wall of the inferior pericardial vena cava. Detailed techniques were described for various scenarios. Clinicopathological data and perioperative outcomes were reported. Group difference statistical analysis was performed.ResultsA total of 26 cases of urinary tumors with supradiaphragmatic IVC thrombus (Mayo grade IV) underwent treatment were enrolled in this study. 19 patients in the PUTH-A group received the open approach without sternotomy and cardiopulmonary bypass. Seven patients in the PUTH-B group received open thoracotomy assisted by cardiopulmonary bypass. No intraoperative death occurred. After 56 months of follow-up, 46.2% (12 of 26) patients died of all causes. Estimated 1-year, 2-year, and 3-year overall survival were 72.0% (95% CI, 54.4%-89.6%), 58.2% (95% CI, 38.0%-78.4%), and 52.4% (95% CI, 31.2%-73.6%), respectively.ConclusionsWe introduced the PUTH grading system for the characteristics of urinary tumors with supradiaphragmatic tumor thrombus, and selected different surgical techniques according to different classifications. This grading system was relatively feasible and effective.

scholarly journals Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

2016 ◽  
Vol 9 (3) ◽  
pp. 599-609 ◽  
Author(s):  
Shuichi Fujita ◽  
Hideaki Takahashi ◽  
Yumiko Kanzaki ◽  
Tomohiro Fujisaka ◽  
Yoshihiro Takeda ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Tumor Resection ◽  
Vena Cava ◽  
Large Mass ◽  
The Past ◽  
Clinical Presentations ◽  
Pulmonary Embolization ◽  
The Right

A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin) followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

Normothermic Cardiopulmonary Bypass with Beating Heart for Management of Renal Cell Carcinoma with Atrial Tumor Thrombus

2013 ◽  
Vol 8 (4) ◽  
pp. 316-319 ◽  
Author(s):  
Domenico Calcaterra ◽  
Thomas E. Collins ◽  
Joseph W. Turek ◽  
Kalpaj R. Parekh ◽  
Mohammad Bashir ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cardiopulmonary Bypass ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
Hospital Length Of Stay ◽  
Advanced Tumor Stage ◽  
The Right

Renal cell carcinoma is occasionally complicated by the formation of a neoplastic thrombus invading the inferior vena cava. Rarely, the thrombus extends into the vena cava, reaching the right atrium. In these situations, despite the advanced tumor stage, surgical resection continues to offer the best chance for effective treatment. The operation requires a complex surgical approach with mobilization of the liver and use, in most cases, of extracorporeal circulation, which allows removal of the tumor thrombus from the right atrium. Traditionally, the intervention is performed using deep hypo-thermic circulatory arrest or, less frequently, using moderate hypothermia, aortic cross clamping, and cardioplegic cardiac arrest. These strategies have the downside of causing increased blood loss, coagulopathy, and long operative time and can potentially have a negative impact on survival. We report a different operative approach using normothermic cardiopulmonary bypass, with the expectation of lowering the rate of blood product transfusions, hospital length of stay, and overall incidence of complications.

scholarly journals Unusual abdominal tumors with intracardiac extension. Two cases with successful surgical resection

1999 ◽  
Vol 54 (5) ◽  
pp. 159-164 ◽  
Author(s):  
Noedir A. G. Stolf ◽  
Gilmar Geraldo dos Santos ◽  
Victor L. S. Haddad
Keyword(s):  
Cardiopulmonary Bypass ◽  
Surgical Resection ◽  
Right Atrium ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Radical Resection ◽  
Abdominal Tumors ◽  
Cardiac Symptoms ◽  
Intracardiac Extension ◽  
The Right

Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Although these tumors have different histologic aspects, they may cause similar abdominal and cardiac symptoms and are a serious risk factor for pulmonary embolism and sudden death when they reach the right atrium and tricuspid valve. The best treatment is radical surgical resection of the entire tumor using cardiopulmonary bypass with or without deep hypothermia and total circulatory arrest. We report the cases of two patients, the first with leiomyosarcoma of the inferior vena cava and the other with intravenous leiomyomatosis of the uterus that showed intravascular growth up to right atrium and ventricle, who underwent successful radical resection in a one-stage procedure with the use of cardiopulmonary bypass. We discuss the clinical and histologic aspects and imaging diagnosis and review the literature.

scholarly journals Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

2021 ◽  
pp. 1-4
Author(s):  
Kabalane Yammine ◽  
◽  
Sarah Khalife ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Treatment Strategies ◽  
Complete Response ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

scholarly journals P169 Uterine leiomyoma extension into right side cardiac

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Diniz Ferrer ◽  
CARLOS Silveira ◽  
ADRIAN Reis ◽  
PAULA Abreu E Lima ◽  
ROBERT Diniz ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Uterine Leiomyoma ◽  
Inferior Vena ◽  
Tumor Resection ◽  
Vena Cava ◽  
Cardiac Imaging Techniques ◽  
First Case ◽  
Adjacent Structures ◽  
The Right

Abstract Funding Acknowledgements governmental grants Uterine leiomyoma is a commom disease in women, however, intravenous leiomyomatosis of uterine origin extending via inferior vena cava into the right side of the heart,known as intracardiac leiomyomatosis is a rare condition (3%). In 1907, Durk reported the first case of intracardiac extension. The patient was a Woman, 35 years old, admitted to our emergency department for an intracardiac mass. She had shortness of breath,fatigue and chest pain. The transthoracic two dimensional echocardiography showed an echogenic oval mass mobile in right atrium and projected through right ventricle in diastole. This mass was observed to extend from inferior vena cava to the right atrium. The echotransesophageal three dimensional showed a large mobile mass that extended from inferior vena cava to the right atrium. A Computer tomographic (CT) scan showed a hypodense multilobulated mass in the pelvis, which had invaded the inferior vena cava and right atrium. The patient underwent a two stages surgery. In first stage (transatrial tumor resection). The operation was performed normal temperature with establisment of cardiopulmonary bypass (CPB). Subsequently, the pathological report was confirmed uterin smooth muscle origin. The second stage surgery ( total histerectomy) was done four weeks later for removing lobulated mass uterin with dimensions 20x15x7.5cm with confirmed histopathological of leiomyoma. Because of it is nonspecific clinical presentation and rarity, an intracardiac Leiomyomatosis continues to be a misdiagnosed as either thrombus or myxoma. The cardiac imaging techniques like a transthoracic echocardiography 2d and transesophageal echocardiography 3d have been used to define the presence, extension of tumor as appearance of the mass and involvement of adjacent structures. Abstract P169 Figure. Echotransesophageal 3D (bicaval view)

scholarly journals Hepatocellular carcinoma tumor thrombus entering the right atrium treated with combining percutaneous and intravenous high-dose-rate brachytherapy: a case report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
F. N. Fleckenstein ◽  
M. Jonczyk ◽  
E. Can ◽  
W. M. Lüdemann ◽  
L. Savic ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dose Rate ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
High Dose Rate ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
Ct Guided ◽  
The Right

AbstractThe presented report describes a case of a Hepatocellular carcinoma (HCC) tumor thrombus (TT) infiltrating the inferior vena cava (IVC) and the right atrium (RA) in a 66-year old male patient who initially presented with TT related symptoms. CT-guided high-dose-rate brachytherapy (HDRBT) was performed for both, the intraparenchymal primary and the TT. A marked improvement of the tumor-related symptoms and shrinkage of the tumor mass were achieved six months after treatment initiation. The combination of intravascular and percutaneous HDRBT demonstrating a promising approach to palliate tumor-related symptoms in advanced HCC with macrovascular invasion.

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