title: Inferior vena cava tumor thrombus after partial nephrectomy for renal cell carcinoma.
abstract: BACKGROUND
  Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common.
  
  
  METHODS
  A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the perirenal fat, and vascular involvement was strongly positive. Thirty months after partial nephrectomy, an enhanced computed tomographic scan showed local recurrence of the renal cell carcinoma extending into the inferior vena cava without renal mass. Hence, we performed right radical nephrectomy and intracaval thrombectomy. Microscopic examination revealed a clear cell carcinoma grade 2, stage pT3a + b. The patient is still alive with no evidence of recurrence 10 months post-procedure.
  
  
  CONCLUSIONS
  To our knowledge, local recurrence of renal cell carcinoma extending into the inferior vena cava after partial nephrectomy has not been reported in the literature. Our case report emphasizes the importance of strict surveillance of patients after partial nephrectomy, especially for those with renal cell carcinoma positive for microvessel involvement.
authors.affiliation: Department of Urology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. s00-001@nms.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Akatsuka
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Takao
authors.initials: T
authors.lastname: Shindo
authors.forename: Masato
authors.initials: M
authors.lastname: Yanagi
authors.forename: Go
authors.initials: G
authors.lastname: Kimura
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kondo
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods; D017131:Thrombectomy; D013927:Thrombosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*