title: Successful treatment of intraoperative pulmonary tumor embolism from renal cell carcinoma.
abstract: During left nephrectomy in a 35-year-old woman with a left renal cell carcinoma extending into the inferior vena cava (IVC) and right atrium, cardiac arrest occurred. Immediate transesophageal echocardiography demonstrated that the event was caused by a pulmonary tumor embolism. Emergent cardiopulmonary bypass (CPB) was established and the tumors in the pulmonary arteries were successfully removed. The left nephrectomy was completed. The patient recovered in the intensive care unit without any neurological deficit. A postoperative pulmonary perfusion scintigram showed no defect in the pulmonary circulation. Transesophageal echocardiography was useful for making a rapid diagnosis of an intraoperative pulmonary embolism originating from a tumor of the IVC or right atrium.
authors.affiliation: Third Department of Surgery, Nara Medical College, Kashihara, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nagasaka
authors.forename: S
authors.initials: S
authors.lastname: Taniguchi
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Kawata
authors.forename: K
authors.initials: K
authors.lastname: Mizuguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Hirao
authors.forename: S
authors.initials: S
authors.lastname: Kitamura
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000473:pathology / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery