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肾血管平滑肌脂肪瘤合并下腔静脉血栓和肺栓塞的多学科管理方法:一例报告

Multidisciplinary approach to the management of renal angiomyolipoma with inferior vena cava thrombus and pulmonary embolism: a case report.

作者信息

Perdue Jordyn, Wells Alexandra, Patel Krishna, Du Plessis Wihan, Varre Jaya, Salibi Patrick

机构信息

Department of General Surgery, OhioHealth Riverside Methodist Hospital, Columbus, OH 43214, United States.

Department of Hepato-Pancreato-Biliary (HPB) Surgery, Atrium Health, Charlotte, NC 28203, United States.

出版信息

J Surg Case Rep. 2024 Mar 22;2024(3):rjae174. doi: 10.1093/jscr/rjae174. eCollection 2024 Mar.

Abstract

Renal angiomyolipoma (AML) is a benign tumor with rare venous extension. We present a case of a patient with renal AML with inferior vena cava (IVC) tumor thrombus and acute pulmonary embolism (PE). A 34-year-old female presented with chest pain. Imaging revealed a 5 cm right renal AML, with tumor thrombus into the renal vein and IVC, and acute left lower lobe PE. Right radical nephrectomy and caval thrombectomy were performed using intraoperative ultrasound. Rarely, these benign tumors generate thrombus with caval extension. The location of IVC thrombus guides surgical planning, which may involve suprahepatic IVC control or cardiopulmonary bypass. Early involvement of a multidisciplinary team with extensive preoperative planning can help achieve successful outcomes.

摘要

肾血管平滑肌脂肪瘤(AML)是一种良性肿瘤,静脉延伸罕见。我们报告一例患有肾AML并伴有下腔静脉(IVC)肿瘤血栓和急性肺栓塞(PE)的患者。一名34岁女性因胸痛就诊。影像学检查显示右肾有一个5厘米的AML,肿瘤血栓延伸至肾静脉和IVC,并伴有急性左下叶PE。术中使用超声进行了右肾根治性切除术和腔静脉血栓切除术。这些良性肿瘤很少会形成延伸至腔静脉的血栓。IVC血栓的位置指导手术规划,这可能涉及肝上IVC控制或体外循环。多学科团队早期参与并进行广泛的术前规划有助于取得成功的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b79/10960940/d2ff66d36cea/rjae174f1.jpg

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