Unanticipated intra-operative finding of pulmonary artery tumour thromboembolism during radical nephrectomy and caval thrombectomy: Case report and management

作者：Sharda Rajan; Deutscher Raymond; Christodoulou Chris; Horne David; Freed Darren H; McGregor Thomas^*

来源：Canadian Urological Association Journal, 2013, 7(5-6): E381-E385.

DOI：10.5489/cuaj.1224

We report a case of an unanticipated intra-operative transesophageal echocardiography (TEE) finding of pulmonary artery thromboembolism in a 72-year-old woman being prepared for radical nephrectomy and caval thrombectomy. Upon intra-operative TEE to evaluate the extent of caval thrombus, we found a pulmonary artery tumour thromboembolism in an otherwise asymptomatic patient after induction and prior to surgery. A chest computed tomography confirmed a large saddle tumour thromboembolus. A multidisciplinary approach was used to facilitate radical nephrectomy with caval thrombectomy and pulmonary artery thromboembolectomy. This case shows the importance of adequate perioperative imaging and use of intra-operative TEE to evaluate the extent of disease. To our knowledge, we are the first to present a case of RCC with cava tumour thrombus in which the pulmonary artery tumour thromboembolism was detected incidentally on intraoperative TEE.

• 出版日期2013-6