A case of huge colon carcinoma and right renal angiomyolipoma accompanied by proximal deep venous thrombosis, pulmonary embolism and tumor thrombus in the renal vein.
A preoperative inferior vena cava (IVC) filter is reported to be effective in surgical cases with proximal deep venous thrombosis (DVT) or in which pulmonary embolism (PE) has already developed, and considered to be at high risk of developing secondary fatal PE during or after surgery. However, guidelines for using an IVC filter have yet to be established. The patient in the present report had two huge tumors, ascending colon cancer and renal angiomyolipoma, which occupied the entire right half of the abdomen, coexisting PE, DVT and tumor thrombus in the right renal vein. Secondary PE is fatal in the perioperative period, therefore, the vena cava filters were preoperatively inserted into the supra- and the infrarenal IVC. We successfully removed the tumors without complications. The patient is alive without tumor recurrence and PE or recurrent DVT 1 year and 6 months after surgery. The coexistence of two huge abdominal tumors as potential causes of PE and DVT is extremely rare, and we could have safely undergone the operation, using two vena cava filters in the supra- and infrarenal IVC.
Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Daisuke
D
Ban
Seiichiro
S
Yamamoto
Hirofumi
H
Kuno
Hiroyuki
H
Fujimoto
Shin
S
Fujita
Takayuki
T
Akasu
Yoshihiro
Y
Moriya
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000368:Aged; D018207:Angiomyolipoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D012082:Renal Veins / Q000473:pathology*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*