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Renal Cell Carcinoma with IVC Thrombus Extending up to Right Atrium and Triple Vessel Coronary Artery Disease - One-stage uro-cardiac Procedure: A case Report

Praveen Pushkar, Shantanu Gore, Ishfaq Ahmad Geelani, Bhaba Nanda Das, Rajesh Taneja

Abstract


Introduction: The aim of this report is to prove the possibility of simultaneous difficult cardiac and urologic operation. Important point to make in our report concerns the fact that the oncologic treatment was not delayed despite severe heart disease. There is also an advantage in avoiding second operation and hence anesthesia

Case Presentation: A 72 year old male presented to us with right renal mass lesion with tumour thrombus extending up to right atrium. He had undergone Percutaneous Transluminal Coronary Angioplasty 5 years ago and had two coronary stents in situ. Coronary angiography revealed triple vessel coronary re obstruction. After proper planning he underwent right radical nephrectomy with tumour thombectomy along with Coronary Artery Bypass Grafting in the same sitting.

Conclusion: One-stage cardiac and uro-oncologic operation can be a safe and beneficial procedure, if performed in selected patients.



Keywords


atrial thrombus; CABG, IVC thrombus; radical nephrectomy; renal cell carcinoma

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References


Campbell MF, Retik RB, Vaughan ED, Walsh PC. Campbell’s Urology, 7th edn. Philadelphia: W.B. Saunders Co., 1998

Nesbitt JC, Soltero ER, Dinney CP et al. Surgical management of renal cell carcinoma with IVC thrombus. Ann Thorac Surg. 1997, 63:1592-1600

Pouliot F, Shuch B, Larochelle JC, Pantuck A, Belldegrun AS. Contemporary management of renal tumours with venous tumour thrombus. J Urol. 2010, 184:833-841

Terakawa T, Miyake H, Takenaka A, Hara I, and Fujisawa M. Clinical outcome of surgical management for patients with renal cell carcinoma involving the inferior vena cava. Int J Urol. 2007, 14:781-784


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