title: Renal cell cancer with invasive atrial tumor thrombus excised off-pump.
abstract: We report a case of a 50-year-old man with right renal cell cancer extending into the inferior vena cava, invading the right atrial wall, and Budd-Chiari syndrome. Because of the patient's coagulopathy and extensive venous collateralization, cardiopulmonary bypass and deep hypothermic circulatory arrest were avoided. Through an abdominal approach, the diaphragm was incised and the right atrium pulled into the abdomen and clamped. The invasive tumor thrombus was sharply excised off the atrial wall. If serious medical conditions do not permit the use of cardiopulmonary bypass, it is technically feasible to excise a wall-invasive atrial tumor thrombus off-pump.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Cerwinka
authors.forename: Gaetano
authors.initials: G
authors.lastname: Ciancio
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Salerno
authors.forename: Mark S
authors.initials: MS
authors.lastname: Soloway
mesh_terms: D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D006325:Heart Atria; D006338:Heart Neoplasms / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating