Left Renal Cell Carcinoma with a Tumor Thrombus in the Inferior Vena Cava: A Case Report

Abstract

A case of Left renal cell carcinoma with a tumor thrombus in the inferior vena cava in a 79-years-old woman is presented. Renal Cell Carcinoma (RCCs) is the most common malignancy of the kidney. Because of shorter right renal vein, the right renal cell carcinoma is more common, the cases of left renal cell carcinoma merging inferior vena cava cancer embolus were rare compared to those in the right. Here, we reported a case is with left renal cell carcinoma with a tumor thrombus in the inferior vena cava. tumor was located at the lower pole of the left kidney with a diameter of about 8.0cm, the cancer embolus was palpable in renal vein and vena cava, the vena cava cancer embolus reached hepatic diaphragm. The venous flow was blocked by blockers, and then vena cava was transected to quickly extract the vena cava cancer embolus. After cutting off the left renal vein, the vena cava incision was stapled by 0 vascular sutures with double continuous anastomosis technique. Then the revascularization of venous flow was performed, the blocking time was about 10min, next the left side of the peritoneum was cut, and the left kidney and tumor were mobilized outside the Gerota's fascia following by transection of left renal artery and ureter until the left kidney, cancer, renal vein cancer embolus and perirenal fat were completely removed. The procedure was performed successfully. The dissection for specimen showed a tumor diameter of 8.0cm, a renal vein embolus size of 6.0cm, a vena cava embolus size of 8.0cm. The postoperative nutritional support and treatment was conducted, the patient recovered well. Pathological examination showed: left renal clear cell carcinoma (Fuhrman's nuclear grading: II).The patients did not receive a post operative chemotherapy. No recurrence and metastasis was found after a two-year follow-up (Figure 1-3). Discussion