Renal cell carcinoma with inferior vena cava tumor thrombus initially misdiagnosed as bland thrombus due to hypercoagulable state

Marina M Tabbara; Ahmed Farag; Gaetano Ciancio

doi:10.1177/2050313X221102019

Renal cell carcinoma with inferior vena cava tumor thrombus initially misdiagnosed as bland thrombus due to hypercoagulable state

SAGE Open Med Case Rep. 2022 May 21:10:2050313X221102019. doi: 10.1177/2050313X221102019. eCollection 2022.

Authors

Marina M Tabbara^{1

2}, Ahmed Farag^{1

2

3}, Gaetano Ciancio^{1

2

4}

Affiliations

¹ Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.
² Miami Transplant Institute, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL, USA.
³ Department of Surgery, School of Medicine, Zagazig University, Zagazig, Egypt.
⁴ Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.

Abstract

Renal cell carcinoma with inferior vena cava tumor thrombus can be misdiagnosed as an inferior vena cava thrombosis if not evaluated carefully with imaging. We describe a case of renal cell carcinoma with inferior vena cava tumor thrombus that was initially misdiagnosed as an inferior vena cava thrombosis due to a possible hypercoagulable state. After 7 months of anticoagulation therapy with no improvement, a right radical nephrectomy and thrombectomy was performed without cardiopulmonary bypass, and a diagnosis of papillary renal cell carcinoma with a level-IIId tumor thrombus was confirmed with no presence of a bland thrombus. We demonstrate the complexity of identifying and treating renal cell carcinoma with venous tumor thrombus and the importance of differentiating between a malignant thrombus and a bland thrombus.

Keywords: Papillary renal cell carcinoma; bland thrombus; hypercoagulable; inferior vena cava tumor thrombus; nephrectomy.

Publication types

Case Reports