Miyamoto M, Shirasawa B, Hayashi Y, Kouchi Y, Miyashita H, Mitsui H, Nasu Y, Hayashida S
Department of Cardiovascular Surgery, Tokuyama Central Hospital, Yamaguchi, Japan.
Kyobu Geka. 1999 May;52(5):364-7.
A case of renal cell carcinoma with a tumor thrombus extending to the right atrium was reported. A 70-year-old woman was admitted with a diagnosis of right renal tumor which had been detected on a routine abdominal ultrasonography. MRI revealed a tumor thrombus extending into the right atrium through the inferior vena cava. A transesophageal echocardiogram confirmed that the tumor extended into the right atrium, and was not adherent to the inferior vena cava and the atrium. Right nephrectomy and removal of the tumor thrombus were performed using extracorporeal circulation. Temporary occlusion of portal venous and hepatic arterial inflow was effective in reducing blood loss. She has been doing well, and there has been no evidence of recurrence during 18 month postoperatively.
报告了一例肾细胞癌伴肿瘤血栓延伸至右心房的病例。一名70岁女性因常规腹部超声检查发现右肾肿瘤而入院。磁共振成像显示肿瘤血栓经下腔静脉延伸至右心房。经食管超声心动图证实肿瘤延伸至右心房,且未粘连于下腔静脉和心房。采用体外循环进行了右肾切除术及肿瘤血栓清除术。临时阻断门静脉和肝动脉血流对减少失血有效。她恢复良好,术后18个月无复发迹象。