Surgical excision of local recurrence with an inferior vena cava tumor thrombus for renal cell carcinoma after laparoscopic partial nephrectomy: a case report and literature review / 中华泌尿外科杂志

ABSTRACT

Objective To report the clinical features,management and prognosis of local recurrence with inferior vena cava tumor thrombus for renal cell carcinoma after laparoscopic partial nephrectomy.Methods A case of 37-year-old man was admitted to hospital for recurrent renal tumor in May 2013.The patient undervent laparoscopic partial nephrectomy for right kidney mass in June 2011,and renal cell carcinoma was diagnosed by pathological examination.The patient complained about pain of right flank in May 2013.Imaging examination (including CT,MRI and PET-CT) showed a 5 cm tumor on the upper-middle right kidney associated with inferior vena cava tumor thrombus,bulky retroperitoneal lymph nodes and extensive local invasion including psoas,ureter,perirenal fascia.Surgical excision of local recurrence,nephrectomy plus inferior vena eava thrombectomy was performed.Results Right nephrectomy and local recurrence incision plus inferior vena eava thrombectomy was performed successfully.The operation time was 360 min,blood loss was 4 000 ml.The patient was discharged on the 14th day after surgery.The pathological characteristics were as followsthe tumor was limited to the upper-middle right kidney,psoas,ureter,and inferior vena cava tumor thrombus,but carcinoma was not found in the lymph nodes,pelvis and others.The final pathological diagnosis was papillary renal cell carcinoma,type Ⅱ.Local recurrence and other distant metastasis were not demonstrated with CT in 12 months' follow-up.Conclusion Excision of locally recurrent renal cell carcinoma is possible,and complete surgical resection could lead to prolonged disease-free survival.