[Treatment of renal cancer extending supradiaphragmatically with fibrinolytics following surgery under extracorporeal circulation, hypothermia and circulatory arrest].
The authors report a case of right renal carcinoma with a supradiaphragmatic vena cava thrombus. The patient presented to the emergency ward with a severe pulmonary embolus managed by fibrinolytic treatment. After alcohol embolization of the tumor, the patient underwent a right radical nephrectomy with cavectomy. A large tumor extending to the heart was removed by cardiopulmonary bypass combined with hypothermia and cardiac arrest. The immediate postoperative course was satisfactory. Eighteen months later, a CT scan revealed a suprarenal growth. A cytological study was performed on a specimen obtained by percutaneous fine needle aspiration under CT guidance and revealed local a recurrence of the renal cell carcinoma. This was removed without any problems. Two years later, no pulmonary metastases have been noted despite, the fibrinolytic therapy.
A
A
Le Duc
G
G
Cariou
P
P
Menasche
P
P
Montete
D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D005112:Extracorporeal Circulation; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology*
D014568:Urokinase-Type Plasminogen Activator
Traitement d'un cancer du rein avec extension supra-diaphragmatique par fibrinolytiques puis chirurgie sous circulation extra-corporelle, hypothermie et arrêt circulatoire.