Anesthetic management of renal cell carcinoma that extended into the right atrium through the inferior vena cava: A case report

Kim, Yoo Kyung; Lee, Yoon Kyung; Lee, Ji Hee; Choi, Seong Soo; Hahm, Kyung Don; Hwang, Jai Hyun

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2010;5(1):60-63.
Published online January 30, 2010.

Anesthetic management of renal cell carcinoma that extended into the right atrium through the inferior vena cava: A case report

Yoo Kyung Kim, Yoon Kyung Lee, Ji Hee Lee, Seong Soo Choi, Kyung Don Hahm, Jai Hyun Hwang

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kdhahm@amc.seoul.kr

Abstract

Renal cell carcinoma (RCC) rarely extends to the cardiac chambers, and the presence of an extension of tumor thrombus to the inferior vena cava or the right atrium has not been shown to determine the survival of patients with RCC.Although an aggressive surgical approach remains the primary treatment for RCC, the anesthetic management remains a difficult intraoperative challenge.We report here on a case of performing cavoatrial tumor thrombectomy and radical nephrectomy in a patient with RCC with an intracardiac extension, and we used cardiopulmonary bypass and intraoperative trans-esophageal echocardiography to assess and treat this tumor.

Key Words: Cardiopulmonary bypass, Cavoatrial thrombectomy, Intracardiac tumor extension, Renal cell carcinoma, Trans-esophageal echocardiography