Alhamdani Zein, Alberto Matthew, Ischia Joseph
Department of Surgery, University of Melbourne, Austin Health, Victoria, Australia.
Urol Case Rep. 2023 May 3;49:102420. doi: 10.1016/j.eucr.2023.102420. eCollection 2023 Jul.
The relationship between thromboembolic events (TEs) and immune-oncology (IO) agents in patients with metastatic renal cell carcinoma (mRCC) with inferior-vena-cava (IVC) thrombus has not been explored despite conferring significant morbidity. A late 30s female is diagnosed with mRCC with a level-II IVC thrombus after presenting with back pain. Two weeks post initiation of immunotherapy, she re-presented with bilateral sub-massive pulmonary emboli requiring IVC and pulmonary thrombectomy. This case exposes a potential relationship between mRCC and IVC thrombus with IO agents that creates a critically hypercoagulable state. This issue requires further investigation given the apparent under-reporting of TEs in these patients.
尽管转移性肾细胞癌（mRCC）合并下腔静脉（IVC）血栓形成会带来严重的发病率，但尚未探讨血栓栓塞事件（TEs）与免疫肿瘤学（IO）药物在这类患者中的关系。一名30多岁的女性在出现背痛后被诊断为mRCC合并II级IVC血栓。免疫治疗开始两周后，她再次出现双侧亚大块肺栓塞，需要进行IVC和肺血栓切除术。该病例揭示了mRCC和IVC血栓与IO药物之间的潜在关系，这种关系会导致严重的高凝状态。鉴于这些患者中TEs明显报告不足，这个问题需要进一步研究。
