2016 Volume 25 Pages 274-277
A 64-year-old female was referred to our hospital due to a right renal tumor. Computed tomography (CT) revealed a 12.0×8.5-cm irregularly shaped solid mass in the right kidney, which was suspected to be a renal carcinoma. CT also indicated that the patient had a duplicated inferior vena cava (IVC); however, the right IVC had already been occluded by the tumor. Furthermore, the tumor extended beyond the right IVC, and it was suspected that it had invaded the aorta. The patient was consequently prepared for elective radical nephrectomy combined with simultaneous resection of the aorta. During surgery, a midline incision and transperitoneal exposure of the right kidney and aorta were performed. The aorta could not be fully exposed because of tumor adhesion. Ligation of the renal vessels was performed to avoid tumor cell dissemination. After being subjected to heparinization, the aorta was resected, and a bifurcated prosthetic graft was inserted uneventfully. The right renal tumor was then resected together with the aortic wall after the administration of protamine. A pathological examination of the specimen revealed that clear cell renal cell carcinoma had invaded the right aortic adventitia. The patient’s postoperative course was uneventful, and no renal disturbance or graft infection occurred. The patient was discharged early from hospital. Renal cell carcinoma associated with aortic invasion is extremely rare so we report this case with reviewing of the literature.
