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Simultaneous surgical management of renal cancer with atrial thrombotic extension and severe chronic coronary artery disease: a case report

Authors :
Giovanni Battista Filomena
Filippo Marino
Eros Scarciglia
Pierluigi Russo
Fabrizio Fantasia
Riccardo Bientinesi
Mauro Ragonese
Nazario Foschi
Gaetano Gulino
Emilio Sacco
Marco Racioppi
Source :
Journal of Medical Case Reports, Vol 17, Iss 1, Pp 1-6 (2023)
Publication Year :
2023
Publisher :
BMC, 2023.

Abstract

Abstract Background Renal cell carcinoma accounts for 2–3% of all malignant cancers in adults and is characterized by the potential development of venous tumor thrombus. Case presentation We present a rare case of a 62-year-old Caucasian man who arrived in the emergency department for monosymptomatic hematuria. Further investigation revealed a right renal cell carcinoma with 16 cm intravascular extension through the renal vein into the inferior vena cava and right atrium associated with significant coronary artery disease based on the computed tomography scan and coronary angiography. To the best of our knowledge, after an extensive literature review, only one similar case has been reported with involvement of the contralateral kidney. Therefore, there are no applicable management recommendations. After performing coronary artery bypass graft surgery, we proceeded with an open right radical nephrectomy and inferior vena cava and right atrium thrombectomy under cardiopulmonary bypass and while the patient’s heart was still beating. The postoperative course went without complications, and the patient was discharged from the hospital on the 10th postoperative day. Conclusions Radical nephrectomy and thrombectomy with reconstruction of the inferior vena cava combined with coronary artery bypass graft can be performed safely and effectively in selected patients with renal cell carcinoma and significant coronary artery disease. Multidisciplinary teamwork and careful patient selection are essential for optimal outcomes.

Details

Language :
English
ISSN :
17521947
Volume :
17
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Medical Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.44f89b77608f428fbf346e876492c4d1
Document Type :
article
Full Text :
https://doi.org/10.1186/s13256-023-04292-3