Successful treatment for a large renal cell carcinoma with tumour thrombus.
We report the case of a 41-year-old man with symptoms of exertional dyspnoea and easy fatigue. Physical examination revealed a palpable mass with knocking pain over the right flank region and a cardiac murmur with jugular vein engorgement. Transoesophageal echocardiography revealed a right atrial mass that caused tricuspid inflow obstruction. Computed tomography revealed a giant mass (approximately 15 x 15 cm2) in the right kidney; this finding was consistent with renal cell carcinoma. Despite the metastatic status, right nephrectomy was performed and the intra-atrial tumour thrombus (TT) was resected under a cardiopulmonary bypass in order to relieve the tricuspid obstruction. Histological examination confirmed renal cell carcinoma with TT. The patient is healthy with satisfactory systolic function at 1-year follow-up.
Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defence Medical Centre, Taipei, Taiwan.
C T
CT
Lin
C S
CS
Tsai
G J
GJ
Hong
Y T
YT
Tsai
C Y
CY
Lee
D000328:Adult; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000601:surgery*; D006338:Heart Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008297:Male; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D017131:Thrombectomy; D016896:Treatment Outcome; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000209:etiology* / Q000601:surgery