[Renal adenocarcinoma with venous tumor extension to the right atrium: diagnostic and therapeutic considerations].

OBJECTIVES

We report our experience in two cases of renal adenocarcinoma with tumor thrombus extending into the right atrium. The literature is reviewed and the diagnostic aspects, surgical techniques, complications, mortality and aspects of retroperitoneal collateral venous blood supply are discussed.

METHODS

The clinical records of both patients are reviewed, with special reference to the diagnostic approach and the surgical technique utilized.

RESULTS

The cephalad portion of the thrombus in the right atrium was accurately defined by MRI. Both patients underwent radical nephrectomy and infrahepatic inferior cavectomy, with cardiopulmonary bypass without cardiocirculatory arrest.

CONCLUSIONS

MRI was the method that best defined the cephalad portion of the tumor thrombus extending into the right atrium. The bypass technique utilized allowed complete removal of the thrombus without intraoperative complications.