Key result
Intraoperative TEE detects unexpected IVC tumor thrombus migration to right cardiac chambers during RCC resection.
Why the study?
Approximately 4%-10% of patients with RCC have tumoral vascular invasion with thrombi in the renal vein and IVC, posing surgical challenges.
Case Report (n=1)
Intraoperative TEE is crucial during nephrectomy and IVC thrombectomy for prompt diagnosis and management of unexpected tumor thrombus migration.
Answers are grounded in this paper and cite their sources.
May support intraoperative TEE vigilance during RCC resection with IVC thrombus; leaves open whether routine use improves outcomes.
Approximately 4%-10% of patients with renal cell carcinoma (RCC) have tumoral vascular invasion with resultant thrombi in the renal vein and in the inferior vena cava (IVC). The authors describe an interesting case of IVC tumor thrombus that migrated to the right cardiac chambers during RCC resection. The diagnosis was made by intraoperative transesophageal echocardiography (TEE), which revealed the presence of a free-floating thrombus between the right atrium (RA) and right ventricle (RV). The patient required an urgent sternotomy with cardiopulmonary bypass (CPB) for atrial thrombus removal prior to the completion of the nephrectomy. The patient made a full recovery and was discharged to a rehabilitation facility. These findings illustrate the importance of intraoperative TEE monitoring during nephrectomy and IVC thrombectomy. In this case, TEE allowed for the diagnosis of an unexpected complication necessitating prompt cardiac surgical management.
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Hatzakorzian et al. (2023) conducted a case report in Renal cell carcinoma with inferior vena cava tumor thrombus (n=1). Intraoperative transesophageal echocardiography (TEE) was evaluated on Diagnosis of tumor thrombus migration. Intraoperative transesophageal echocardiography successfully diagnosed an unexpected migration of an inferior vena cava tumor thrombus to the right cardiac chambers during renal cell carcinoma resection.
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