Key result
Off-pump IVC thrombectomy successfully treats Level III renal cell carcinoma thrombus with zero 1-year recurrence.
Why the study?
Renal cell carcinoma with inferior vena cava tumor thrombus is associated with increased surgical complexity and significant prognostic implications.
Case Report (n=1)
This case demonstrates that a massive renal cell carcinoma with a Level III IVC tumor thrombus can be clinically silent and successfully managed with radical nephrectomy and thrombectomy without cardiopulmonary bypass.
Supports bypass-free resection in select asymptomatic Level III cases; leaves open need for prospective validation before wider adoption.
Renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus represents a complex clinical entity associated with increased surgical complexity and significant prognostic implications. We report the case of a 49-year-old asymptomatic male patient who was incidentally diagnosed with a massive right renal tumor with a Level III IVC tumor thrombus on imaging. The patient underwent successful right radical nephrectomy with IVC thrombectomy without the need for cardiopulmonary bypass. Histopathological examination confirmed clear cell RCC, Fuhrman grade II, with malignant thrombus and negative surgical margins. The final pathological stage was pT3bNxM0, corresponding to Stage III disease. This case highlights the importance of accurate preoperative imaging, multidisciplinary surgical planning, and meticulous vascular control in achieving successful thrombectomy of a Level III IVC tumor thrombus without cardiopulmonary bypass.
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Deep et al. (2026) conducted a case report in Renal cell carcinoma with Level III inferior vena cava tumor thrombus (n=1). Right radical nephrectomy with IVC thrombectomy was evaluated on Surgical success and 1-year recurrence. Right radical nephrectomy with IVC thrombectomy without cardiopulmonary bypass was successfully performed for a massive asymptomatic RCC with Level III IVC tumor thrombus, with no recurrence at one year.
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