Minervini Andrea, Salinitri Giuseppe, Lera Jacopo, Caldarelli Claudio, Caramella Davide, Minervini Riccardo
Department of Surgery, Urology and Vascular Surgery Unit, University of Pisa, Pisa, Italy.
Int J Urol. 2004 Apr;11(4):239-42. doi: 10.1111/j.1442-2042.2003.00777.x.
We report an unusual case of solitary thrombus floating in the inferior vena cava (IVC) in a patient who underwent radical nephrectomy for a renal cell carcinoma (RCC) of the right kidney extended into the renal vein with no capsular and perinephric tissue invasion (pT3b). Twenty months after surgery, a routine computed tomography scan identified an intraluminal mass floating in the IVC. Cavotomy and thrombectomy with no caval resection were successfully performed. A review of the literature showed only three previous published cases of RCC recurring in the IVC only, with no local recurrence or distant metastases. We outline the possible etiology of these unusual and solitary recurrences in the IVC and we emphasize the need for a strict surveillance for all patients with RCC and especially for those with pT1b, pT2 and pT3 disease. An early diagnosis of this rare recurrence can permit an easy removal of the thrombus with no caval resection and graft replacement, making this disease potentially curable by surgery.
我们报告了一例罕见病例，一名因右肾肾细胞癌（RCC）行根治性肾切除术的患者，肿瘤侵犯肾静脉但无包膜及肾周组织侵犯（pT3b），术后20个月，常规计算机断层扫描发现下腔静脉（IVC）内有一漂浮的腔内肿块。成功实施了不切除下腔静脉的开腔取栓术。文献回顾显示，此前仅有3例仅在下腔静脉复发的肾细胞癌病例报道，无局部复发或远处转移。我们概述了下腔静脉内这些罕见且孤立性复发的可能病因，并强调对所有肾细胞癌患者，尤其是pT1b、pT2和pT3期疾病患者进行严格监测的必要性。早期诊断这种罕见的复发情况，可在不切除下腔静脉及进行移植置换的情况下轻松取出血栓，使该疾病有可能通过手术治愈。
