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Carcinoma de células renais com extensão até à aurícula direita. Caso clínico

Title
Carcinoma de células renais com extensão até à aurícula direita. Caso clínico
Type
Article in National Scientific Journal
Year
2008
Authors
Vilaça I.
(Author)
Other
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Pinto J.P.
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Teixeira J.
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FMUP
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Casanova J.
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FMUP
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Torres J.
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FMUP
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Oliveira R.
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Roncon Albuquerque R.
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FMUP
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Scientific classification
CORDIS: Health sciences > Medical sciences > Medicine > Surgery
Other information
Resumo (PT): : Os autores descrevem um caso clínico de um carcinoma de células renais com extensão até à aurícula direita, numa mulher de 48 anos de idade. A doente foi submetida a cirurgia com remoção total do trombo tumoral e nefrectomia, com bypass cardiopulmonar e hipotermia. O estudo anatomapatológico revelou tratar-se de um carcinoma de células renais sem invasão da cápsula renal. Dezoito meses após a cirurgia a doente mantém assintomática e a efectuar terapêutica com imunosupressores por suspeita de metásteses mediastinicas. Os autores discutem a morbilidade, a mortalidade e a sobrevida após a cirurgia, com base em casos clínicos semelhantes publicados na literatura. Alguns estudos sugerem que nos doentes com carcinoma de células renais localizado, a extensão do trombo tumoral na veia cava inferior não influência significativamente o prognóstico.
Abstract (EN): We report the clinical case of a 48-year-old woman with advanced renal cell carcinoma, and an inferior vena cava thrombus extending into the right atrium. The patient underwent complete tumor excision with radical nephrectomy and inferior vena cava trombectomy using adjunctive cardiopulmonary bypass and deep hypothermic circulatory arrest. Pathological studies revealed no capsular invasion by the renal cell carcinoma. Eighteen months postoperatively the patient is asymptomatic and on immunosuppresive therapy for suspected metastatic disease. We discuss the morbilidity, mortality and long term survival of patients with similar presentation of renal cell carcinoma based in a review of the published literature. Long term survival after surgical treatment is possible in a patient with localized renal cell carcinoma extending into the right atrium. In patient with localized renal cell carcinoma and inferior vena cava tumor thrombus the cephalad extend of inferior vena caval involvement does not appear to influence the progress.
Language: Portuguese
Type (Professor's evaluation): Scientific
Contact: Isabel Vilaça
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