Extracorporeal Partial Nephrectomy with Orthotopic Autotransplantation under Pharmaco-Cold Ischaemia for Cancer of a Single Kidney: A Case Report.

Up to 10% of patients with renal cell carcinoma (RCC) have locally advanced disease with venous tumour thrombosis involving the inferior vena cava (IVC). 30-50% of them present with synchronous metastatic disease. Surgical treatment remains the only potentially radical method for patients suffering from RCC and IVC tumour thrombosis without distant metastases. Five-year cancer-specific survival for such patients is 40-60%. The role of surgery in the treatment of RCC is significant, even if only cytoreductive operation is possible. Nephron-sparing surgery (NSS) is reasonably preferable for patients suffering from single kidney RCC, but it is not always radical enough. Extracorporeal approach allows to perform a radical dissection of the tumour in special complicated cases, but it is seldom used because of technical difficulties. We present a case of successful NSS by extracorporeal approach in our modification for RCC with IVC tumour thrombosis.

Leiomyosarcoma of the inferior vena cava.

Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignancy. Approximately 350 cases of this disease are known worldwide. Surgical treatment of this condition remains an extremely difficult task. In this case report, we present an experience of successful radical treatment of a leiomyosarcoma of the suprarenal IVC without vascular reconstruction. The patient was treated with resection of the suprarenal portion of the IVC with the tumor; however, in view of adequate blood outflow from the right lobe of the liver, prosthetic replacement of the IVC with right hepatic vein reimplantation was not performed.

Two-stage combined treatment of leiomyosarcoma of iliac vein using robotic surgery.

Vascular leiomyosarcoma is a rare tumor originating from the vascular smooth muscle cells. Leiomyosarcomas of the external iliac vein are extremely rare. Only single observations of this tumor are reported. We describe a 48-year-old woman who underwent a two-step combined treatment: robot-assisted removal of the extraperitoneal tumor and removal of the lower part of the tumor from the open femoral approach. There have been no signs of tumor recurrence during the 34-month follow-up period.

Successful surgical treatment with ex vivo technique in a patient with renal artery aneurysm rupture and bilateral arteriovenous fistula.

Renal arteriovenous fistulas are pathologic communications between the renal arteries and veins without interconnecting capillaries. Reports on the combination of fibromuscular dysplasia, aneurysms, and renal arteriovenous fistula are extremely rare in the literature. In the case of renal arteriovenous aneurysm rupture, urgent nephrectomy was the only life-saving procedure reported. The ex vivo approach seems to be an appropriate alternative to nephrectomy. This article presents a case of successful treatment of bilateral fibromuscular dysplasia with aneurysm and arteriovenous fistulas complicated by renal artery aneurysm rupture.