Massive Tumor Embolism Research Articles

Death Due to Embolic Renal Cell Carcinoma

Abstract Introduction/Objective While most pulmonary embolisms are composed of blood clot resulting from venous stasis, tumor embolism is rarely encountered. We describe an autopsy patient with an unexpected renal cell carcinoma (RCC) who expired after a massive tumor embolism to the pulmonary artery. Methods/Case Report A 56-year-old male presented with complaints of shortness of breath and was found to have a large right-sided pulmonary embolism with an incidental finding of a 9.0 cm right kidney mass on imaging. He was subsequently admitted for further management consisting of thrombo-aspiration. The procedure was largely unsuccessful and the patient’s respiratory status continued to decline and he subsequently expired. On autopsy, a 9.3 x 6.2 x 6.0 cm, yellow-tan, well-defined mass was discovered primarily in the lower pole of the right kidney with invasion into the hilar structures. The mass grossly appeared to be invading into the renal vein. Two large yellow-tan emboli were found to be causing significant obstruction of the inferior vena cava at the level of the right renal vein and in the right pulmonary artery. Microscopic evaluation revealed the kidney tumor to be consistent with renal cell carcinoma morphologically and immunohistochemically. Interestingly, all emboli discovered at autopsy are primarily composed of sheets of cells identical to the patient’s renal mass. It is therefore concluded that the patient’s kidney cancer invaded into the renal vein and embolized to the pulmonary artery, ultimately resulting in death. Results (if a Case Study enter NA) NA Conclusion Tumor embolism is a rare cause of death. Renal cell carcinoma is a relatively common neoplasm that has been described to present as a tumor thrombus in 13.3% of patients. Of these patients with RCC tumor thrombus, 1% embolize to the right atrium. Our case represents this rare phenomenon and demonstrates why it is crucial to confirm the contents of a pulmonary embolism, as not all are composed of blood components alone.

A stitch in time saves life: Massive tumor embolism.

A stitch in time saves life: Massive tumor embolism.

Value of Transoesophageal Echocardiography for Diagnosis of Intraoperative Tumour Embolization

Malignant neoplasms such as renal cell carcinoma may invade the inferior vena cava leading to a risk of pulmonary tumour embolization during surgical excision. Although massive pulmonary tumour embolism occurs relatively rarely, it can have catastrophic consequences. We report the case of an acute intraoperative pulmonary tumour embolism during resection of a renal cell carcinoma. The use of transoesophageal echocardiography allowed the immediate diagnosis and appropriate management of the underlying cause of acute haemodynamic instability. The role of transoesophageal echocardiography in the diagnosis of pulmonary embolism is discussed.

A Massive Pulmonary Tumor Embolism After Surgical Manipulation and Biopsy of a Pelvic Mass

A Massive Pulmonary Tumor Embolism After Surgical Manipulation and Biopsy of a Pelvic Mass

Extraskeletal Ewing's sarcoma presenting with pulmonary embolism

Small round cell tumours with the morphologic characteristics of Ewing's sarcoma arise rarely in soft tissues of the extremities, retroperitoneum, chest and orbit. Patients usually present with symptoms arising from the swelling at the primary site. We report on a patient with a retroperitoneal extraskeletal Ewing's sarcoma who presented with massive tumour embolism to the pulmonary vasculature. To our knowledge, this is the first report of extraskeletal Ewing's sarcoma presenting with pulmonary tumour embolism.

Embolie pulmonaire massive peropératoire d'origine tumorale. Intérêt d'un monitorage extensif

A case is reported of a 47-year-old female patient who suffered from massive tumour embolism during a nephrectomy for a renal carcinoma invading the inferior vena cava. Intraoperative monitoring consisted in direct blood pressure measurement (radial artery cannula), central haemodynamic monitoring (Swan-Ganz catheter), pulse oximetry and capnography. During the surgical manipulation of the suprahepatic vena cava, Petco 2 suddenly decreased (from 25 mmHg to 14 mmHg), together with Spo 2 (from 99 % to 89 %), and the mean pulmonary arterial pressure increased from 18 mmHg to 40 mmHg. The drop in arterial blood pressure to 50/30 mmHg, initiated an immediate sternotomy. After clamping the superior and inferior venae cavae, numerous tumour fragments were removed from the pulmonary artery. Cardiac activity restarted after internal cardiac massage, 1 mg adrenaline, 1 g calcium chloride and 150 mmol of molar sodium bicarbonate. The whole procedure lasted 30 min. Arterial blood pressure became stable at 110/50 mmHg, pulmonary arterial and wedge pressures at 20 and 5 mmHg. The Spo 2 increased to 98 %, and Petco 2 to 25 mmHg. The nephrectomy was then carried out, the patient being given 5 μg · kg −1 · min −1 dobutamine and 3 μg · kg −1 · min −1 dopamine. At the end of surgery, systolic blood pressure was 120 mmHg, mean pulmonary arterial pressure 25 mmHg, and Paco 2 34 mmHg. The patient left the intensive care unit after twelve days. After one year of follow-up, no complication had occurred. The value of cardiopulmonary bypass in nephrectomy for renal carcinoma invading the vena cava, or the renal vein, is discussed. Pulse oximetry and capnography helped to make an early diagnosis of tumour embolism ; the usefulness of this type of monitoring is underlined.

An Anesthetic Experience of Massive Tumor Embolism during Lung Tumor Surgery

An Anesthetic Experience of Massive Tumor Embolism during Lung Tumor Surgery

Sudden death from massive tumor embolization of chondrosarcoma. Report of a case.

Sudden death from massive tumor embolization of chondrosarcoma. Report of a case.

Massive Tumor Embolism Occurring During Pneumonectomy

A case of gross tumor embolism occurring during pneumonectomy for giant cell carcinoma is presented. Seven similar cases of massive tumor embolism during pulmonary resection for malignant disease have been previously described. Ours is the first recorded patient to have survived such an episode.

Latent choriocarcinoma.

Six previously reported cases of latent choriocarcinoma are reviewed and a new case presented. The patient died from massive pulmonary tumor embolization, a previously unreported phenomenon. Possible mechanisms of latency are discussed.

Massive systemic tumor embolization during pneumonectomy: a case report with comments on routine primary pulmonary vein ligation.

Massive systemic tumor embolization during pneumonectomy: a case report with comments on routine primary pulmonary vein ligation.

Massive Tumour Embolism

Massive Tumour Embolism