Rapidly Progressing Renal Cell Carcinoma With Unexpected Inferior Vena Cava Tumor Thrombus

Q4 Medicine

IJU Case Reports Pub Date : 2025-03-12 DOI:10.1002/iju5.70014

Sohei Iwagami, Masaya Nishihata, Shimpei Yamashita, Isao Hara, Fumiyoshi Kojima, Yasuo Kohjimoto

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Abstract

Introduction

We report here a case of RCC without preoperative tumor thrombus that had progressed to RCC with IVC tumor thrombus.

Case Presentation

A 75-year-old man was referred to our hospital. Contrast-enhanced CT showed a 50-mm mass in the right kidney with an indistinct border, contrast in the early phase and washout in the late phase. RARN was attempted for RCC. Intraoperatively, a tumor thrombus was unexpectedly observed. We converted to open surgery, and the right kidney and tumor thrombus were removed. Postoperative lymphorrhea was observed, but the patient recovered without any problems. Lung and bone metastases subsequently appeared, and the patient died 2 months later.

Conclusions

Surgeons should keep in mind that a tumor thrombus can grow rapidly before performing surgery for renal cell carcinoma.

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快速进展肾细胞癌伴意外下腔静脉肿瘤血栓

我们在此报告一例术前无肿瘤血栓的肾小细胞癌发展为伴有下腔静脉肿瘤血栓的肾小细胞癌。一名75岁男子转诊至我院。增强CT示右肾一50 mm肿块，边界不清，早期呈对比，晚期呈消失。为RCC尝试RARN。术中意外发现肿瘤血栓。我们转为开放手术，右肾和肿瘤血栓被移除。术后观察到淋巴漏，但患者恢复无任何问题。随后出现肺和骨转移，患者2个月后死亡。结论外科医生在肾细胞癌手术前应注意肿瘤血栓的快速生长。

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