Successful interdisciplinary treatment of renal cell carcinoma with tumour thrombus into inferior vena cava using multimodal protocol and organ-extending R0 resection in rare horseshoe kidney and doubled right organ

This is the first case ever reported showing a combination of renal cell carcinoma (RCC) with tumour thrombus into inferior vena cava (IVC), horseshoe kidney and doubled right kidney that was successfully treated. Even in advanced tumour lesions of the kidney, curative treatment is a feasible and sa...

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Bibliographic Details
Published in:BMJ case reports 2010-05, Vol.2010 (may26 1), p.bcr0420091802-bcr0420091802
Main Authors: Janitzky, Andreas, Meyer, Frank, Halloul, Zuhir, Porsch, Markus, Daher, Majed, Kuester, Doerthe, Pech, Maciej, Liehr, Uwe-Bernd
Format: Article
Language:English
Subjects:
Abdomen
Adrenalectomy
Blood clots
Carcinoma, Renal Cell - diagnosis
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - surgery
Cooperation
Creatinine
Diagnosis, Differential
Europe (West)
Histology
Hospitals
Humans
Interdisciplinary aspects
Kidney - abnormalities
Kidney cancer
Kidney Neoplasms - diagnosis
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Lymph Node Excision
Lymphatic system
Male
Medical imaging
Metastasis
Middle Aged
Neoplasm Staging
Rare Disease
Surgeons
Thrombosis - pathology
Thrombosis - surgery
Tomography, X-Ray Computed
Veins & arteries
Vena Cava, Inferior - pathology
Vena Cava, Inferior - surgery
White
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Summary:This is the first case ever reported showing a combination of renal cell carcinoma (RCC) with tumour thrombus into inferior vena cava (IVC), horseshoe kidney and doubled right kidney that was successfully treated. Even in advanced tumour lesions of the kidney, curative treatment is a feasible and safe option by using interdisciplinary cooperation and expertise. However, this requires an adequate diagnostic work-up to clarify resectability and optimal perioperative and postoperative care, and also advanced surgical skills exhausting all potential options for complete tumour resection in a centre of excellence. Achieving R0 resection with a reasonable risk-benefit ratio for the patient, which should be the primary aim, can distinctly improve survival chances as published cases in literature have indicated. RCC-derived IVC tumour thrombus as an extra-renal tumour manifestation by continuous intravascular tumour growth (also classified as secondary IVC tumour lesion) can be considered no serious contraindication to aim for curative surgery.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.04.2009.1802