Abstract
We report a unique case of renal cell carcinoma encasing the inferior vena cava (IVC). There was no distant metastasis, lymph node involvement, gross renal vein or IVC tumor invasion, which was misleading! The anesthetic management was challenging and the outcome fatal. The only forewarning signs of impending catastrophe were the presence of a small tumor thrombus in IVC detected on ultrasound abdomen and the CT scan report of IVC being encased by the renal cell carcinoma. Our failure to recognize the implications of IVC encasement resulted in a disastrous outcome. The surgical intervention, anesthetic management and an unexpected fatal outcome have been discussed. IMPLICATION STATEMENT Surgical management of renal cell carcinoma encasing and invading the inferior vena cava can result in massive intraoperative hemorrhage and death. Awareness of this complication and adequate anesthetic preparation for it have been discussed.
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