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A 56-year-old man with a known renal tumour presenting with aortobifemoral thromboembolism was successfully treated with bilateral femoral embolectomy, excision of a left atrial myxoma, and partial nephrectomy.
Case Report (n=1)
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This case highlights the diagnostic and management challenges of a patient presenting with multiorgan complications from aortobifemoral thromboembolism due to a left atrial myxoma, concurrent with a renal cell carcinoma.
A 56-year-old man presented with aortobifemoral thromboembolism, ischaemic paraplegia, rhabdomyolysis and acute renal tubular necrosis while awaiting nephrectomy for a right renal tumour. An echocardiogram to investigate the source of embolism revealed a 7 x 3 cm mass attached to the left atrial septal wall which prolapsed through the mitral valve. The patient successfully underwent bilateral femoral embolectomy and staged operations for the excision of the left atrial mass, reported on histopathology as myxoma, and open partial nephrectomy of a high grade papillary type renal cell carcinoma. We discuss the dilemmas of diagnosis and the staging of various surgical interventions in a patient of known malignancy who presents with aortobifemoral thromboembolism with multiorgan complications and also harbours a cardiac mass which could be another thrombus, an unrelated primary benign or malignant tumour or a metastasis from the primary renal tumour.
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Kaul et al. (2012) conducted a case report in Left atrial myxoma with aortobifemoral thromboembolism and renal cell carcinoma (n=1). Bilateral femoral embolectomy, excision of left atrial mass, and open partial nephrectomy was evaluated. A 56-year-old man with a known renal tumour presenting with aortobifemoral thromboembolism was successfully treated with bilateral femoral embolectomy, excision of a left atrial myxoma, and partial nephrectomy.
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