title: Lessons Still Being Learned: Acute Pulmonary Tumor Embolus During Renal Cell Carcinoma Resection.
abstract: Renal cell carcinoma (RCC) is the most common primary renal neoplasm and is associated with the intraluminal growth into the venous system with possible extension into the inferior vena cava or even right heart. Intraoperative pulmonary embolism is a complication of resection of RCC, which may be mitigated by the use of the cardiopulmonary bypass with or without deep hypothermic circulatory arrest. We present a case of unexpected pulmonary embolism diagnosed during RCC surgery. The case highlights the central importance of intraoperative transesophageal echocardiography use and the need for proper preoperative planning for the use of cardiopulmonary bypass.
authors.affiliation: From the *Department of Anesthesiology and Critical Care Medicine, University of New Mexico, Albuquerque, New Mexico; and †Division of Urology, Department of Surgery, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Neal S
authors.initials: NS
authors.lastname: Gerstein
authors.forename: Ran
authors.initials: R
authors.lastname: Zhang
authors.forename: Michael S
authors.initials: MS
authors.lastname: Davis
authors.forename: Harish
authors.initials: H
authors.lastname: Ram
mesh_terms: D000208:Acute Disease; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D007858:Learning; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology