Successful Treatment for a Large Renal Cell Carcinoma with Tumour Thrombus

Abstract

We report the case of a 41-year-old man with symptoms of exertional dyspnoea and easy fatigue. Physical examination revealed a palpable mass with knocking pain over the right flank region and a cardiac murmur with jugular vein engorgement. Transoesophageal echocardiography revealed a right atrial mass that caused tricuspid inflow obstruction. Computed tomography revealed a giant mass (approximately 15 χ 15 cm²) in the right kidney; this finding was consistent with renal cell carcinoma. Despite the metastatic status, right nephrectomy was performed and the intraatrial tumour thrombus (TT) was resected under a cardiopulmonary bypass in order to relieve the tricuspid obstruction. Histological examination confirmed renal cell carcinoma with TT. The patient is healthy with satisfactory systolic function at 1-year follow-up.

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C.Y. Lee

Chung-Yi Lee, M.D. Division of Cardiovascular Surgery, Department of Surgery Tri-Service General Hospital, No. 325 Cheng-Kung Rd, Sec 2, Taipei 114, Taiwan Tel.: [phone] Fax: [phone] E-mail: [email protected]