Level IV tumor thrombus in non-metastatic renal cell cancer? No, thanks. Level II is better. Lessons learned from a case report

Andrea Benedetto Galosi; Alessio Papaveri; Daniele Castellani; Edoardo Agostini; Luciano Burattini; Lucio Dell'Atti

doi:10.1016/j.eucr.2021.101660

Level IV tumor thrombus in non-metastatic renal cell cancer? No, thanks. Level II is better. Lessons learned from a case report

Urol Case Rep. 2021 Mar 25:37:101660. doi: 10.1016/j.eucr.2021.101660. eCollection 2021 Jul.

Authors

Andrea Benedetto Galosi¹, Alessio Papaveri¹, Daniele Castellani¹, Edoardo Agostini¹, Luciano Burattini², Lucio Dell'Atti¹

Affiliations

¹ Department of Specialist Clinical Science and Odontostomatology, Urology Division, Università Politecnica delle Marche, Via conca 71, 60126, Ancona, Italy.
² Department of Molecular and Clinical Science, Medical Oncology Division, Università Politecnica delle Marche, Via conca 71, 60126, Ancona, Italy.

Abstract

Up to 19% of patients with renal cell carcinoma present with a venous thrombus at diagnosis and 1% have a thrombus extending above the diaphragm. The higher the thrombus level, the more challenging the surgery. Cavoatrial tumor thrombus usually requires circulatory arrest and sometimes cardiopulmonary by-pass. We present a case of non-metastatic renal cell carcinoma with a cavoatrial tumor thrombus in a patient who was unfit for cardiac surgery. Eight months of targeted molecular therapy downsized the tumor thrombus to inferior vena cava and allowed us to perform a radical nephrectomy with minimal cavothomy for thrombus resection.

Keywords: Cavoatrial tumor thrombus; Kidney neoplasms; Pazopanib; Targeted molecular therapies.

Publication types

Case Reports