title: Pediatric clear cell sarcoma of the kidney with atriocaval thrombus.
abstract: Clear cell sarcoma of the kidney (CCSK) is an uncommon neoplasm that accounts for almost 3 % of pediatric renal tumors. Cavoatrial tumor thrombosis is very rare and because of poor response to chemotherapy, invasive surgical interventions such as open heart surgery may be indicated. A 6-year-old girl with CCSK of right kidney was treated with neoadjuvant chemotherapy. According to poor chemosensitivity, surgical intervention was planned. Right atriotomy was done, but intra-atrial part of tumor was very firm and unsuctionable; so the procedure was completed by laparotomy and en bloc resection of tumoral kidney and its cavoatrial extension through a limited venotomy on inferior vena cava. Although radical resection of CCSK with intracaval involvement should be considered as a multidisciplinary approach and intensive care and supports should be provided, atriocaval tumor in growth in CCSK is firm, non friable and non-adherent, and tumor en bloc resection may be possible through a limited venotomy via primary abdominal approach.
authors.affiliation: Mashhad Medical University, Mashhad, Khorasan, Islamic Republic of Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Hiradfar
authors.forename: Nona
authors.initials: N
authors.lastname: Zabolinejad
authors.forename: Reza
authors.initials: R
authors.lastname: Shojaeian
authors.forename: Parisa
authors.initials: P
authors.lastname: Saeedi
authors.forename: Marjan
authors.initials: M
authors.lastname: Joodi
authors.forename: Reza
authors.initials: R
authors.lastname: Nazarzadeh
authors.forename: Hamid
authors.initials: H
authors.lastname: Farhangi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abbasi Tashnizi
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Alamdaran
mesh_terms: D002648:Child; D005260:Female; D006325:Heart Atria; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D018227:Sarcoma, Clear Cell / Q000556:secondary*; D014682:Vena Cava, Inferior