Background:

Renal cell carcinoma accounts for 2 to 3% of all malignant neoplasias in the adult. It has an incidence of 84,400 new cases annually and more than 34,000 deaths are attributed to the disease per year. Kidney cancer has a preference for invading the venous system in 10% of cases, with the possibility of affecting the renal vein and the inferior vena cava with the presence of tumor thrombi.

Clinical case:

A 48-year-old man had a history of smoking and presented with no chronic degenerative diseases. He had clinical symptom onset of abdominal pain and increased abdominal perimeter, weight loss, and edema in his right pelvic limb, 2 months earlier. Physical examination revealed a right hemiabdominal tumor and edema of the right leg. A contrast-enhanced tomography scan identified a right kidney tumor and tumor thrombus at the level of the atrium. A transesophageal echocardiogram showed the presence of a right atrial tumor thrombus.

Conclusion:

Radical nephrectomy and thrombectomy with cavotomy and atriotomy are standard management for intention-to-cure treatment in patients with renal cell carcinoma and supradiaphragmatic tumor thrombi.