Tabbara Marina M, Farag Ahmed, Ciancio Gaetano
Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.
Miami Transplant Institute, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL, USA.
SAGE Open Med Case Rep. 2022 May 21;10:2050313X221102019. doi: 10.1177/2050313X221102019. eCollection 2022.
Renal cell carcinoma with inferior vena cava tumor thrombus can be misdiagnosed as an inferior vena cava thrombosis if not evaluated carefully with imaging. We describe a case of renal cell carcinoma with inferior vena cava tumor thrombus that was initially misdiagnosed as an inferior vena cava thrombosis due to a possible hypercoagulable state. After 7 months of anticoagulation therapy with no improvement, a right radical nephrectomy and thrombectomy was performed without cardiopulmonary bypass, and a diagnosis of papillary renal cell carcinoma with a level-IIId tumor thrombus was confirmed with no presence of a bland thrombus. We demonstrate the complexity of identifying and treating renal cell carcinoma with venous tumor thrombus and the importance of differentiating between a malignant thrombus and a bland thrombus.
肾细胞癌合并下腔静脉瘤栓如果不通过影像学仔细评估，可能会被误诊为下腔静脉血栓形成。我们描述了一例肾细胞癌合并下腔静脉瘤栓的病例，该病例最初因可能存在的高凝状态而被误诊为下腔静脉血栓形成。在进行了7个月的抗凝治疗且无改善后，在未进行体外循环的情况下实施了右肾根治性切除术和血栓切除术，最终确诊为伴有Ⅲd级瘤栓的乳头状肾细胞癌，不存在单纯性血栓。我们展示了识别和治疗伴有静脉瘤栓的肾细胞癌的复杂性，以及区分恶性血栓和单纯性血栓的重要性。
