CARCINOMA DE CÉLULAS RENAIS COM TROMBO GIGANTE NA VEIA CAVA INFERIOR – ABORDAGEM CIRÚRGICA MULTIDISCIPLINAR | RENAL CELL CARCINOMA WIHT GIANT CAVAL THROMBUS – MULTIDISCIPLINARY SURGICAL APPROACH

Andrea Furtado, Bruno Graça, Frederico Bastos Gonçalves, Fernando Ferrito, Aragão Morais, Álvaro Laranjeira Santos

Resumo


RESUMO
A nefrectomia radical associada a trombectomia da veia cava inferior constitui a única opção terapêutica passível de
melhoria prognóstica dos carcinomas de células renais com trombos venosos major. Descrevemos o caso de um homem, 55
anos, com o diagnóstico de tumor renal com trombo intra-cávico de grandes dimensões. O doente foi alvo de uma abordagem multidisciplinar, tendo sido submetido a nefrectomia radical à direita, trombectomia e cavoplastia, com recurso ainda
a bypass cardiopulmonar e circulação extra-corpórea. O pós-operatório não registou intercorrências. A análise histológica
concluiu tratar-se de um carcinoma de células renais, variante células claras e trombo excisado na totalidade, sem invasão da
parede venosa. Aos dois anos de pós-operatório o doente encontra-se sem evidência de recidiva tumoral nem foram descritos
eventos de embolização pulmonar.

Palavras-chave: tumor do rim, trombectomia, nefrectomia radical, circulação extra-corpórea.

ABSTRACT
Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the effective therapeutic option in patients with renal cell
carcinoma (RCC) infiltrating IVC. Here in we report a case of a 55 year-old man with RCC and a giant occlusive IVC tumoral thrombus.
The patient underwent right nephrectomy and thrombectomy with cavoplasty with cardiopulmonary bypass. The postoperative course was
uneventful. The histological exam suggested complete resection of the tumor and no vascular wall involvement of the tumoral thrombus. Two
years past surgery the patient is disease free and there are no signs of pulmonary embolization or vascular thrombus formation.

Key-words:kidney neoplasm, thrombectomy, radical nephrectomy, extracorporeal circulation.


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Referências


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