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

Authors

  • Rajan Sharda Section of Urology, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
  • Raymond Deutscher Department of Surgery and Anesthesia, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
  • Chris Christodoulou Department of Surgery and Anesthesia, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
  • David Horne Section of Cardiac Surgery, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
  • Darren H. Freed Section of Cardiac Surgery, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
  • Thomas McGregor Section of Urology, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB

DOI:

https://doi.org/10.5489/cuaj.1224

Abstract

We report a case of an unanticipated intra-operative transesophageal echocardiography (TEE) finding of pulmonary artery thromboembolism in a 72yr woman being prepared for radical nephrectomy and caval thrombectomy.  Intra-operative TEE performed to evaluate the extent of caval thrombus found the presence of pulmonary artery tumor thromboembolism in an otherwise asymptomatic patient after induction and prior to commencing surgery.  A chest Computed Tomography (CT) scan confirmed a large saddle tumor thromboembolus.   A multidisciplinary approach was utilized to facilitate radical nephrectomy with caval thrombectomy and pulmonary artery thromboembolectomy.  This case shows the importance of adequate perioperative imaging and utilization 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.

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Published

2013-05-13

How to Cite

Sharda, R., Deutscher, R., Christodoulou, C., Horne, D., Freed, D. H., & McGregor, T. (2013). Unanticipated intra-operative finding of pulmonary artery tumour thromboembolism during radical nephrectomy and caval thrombectomy: Case report and management. Canadian Urological Association Journal, 7(5-6), e381–5. https://doi.org/10.5489/cuaj.1224

Issue

Vol. 7 No. 5-6 (2013): CUAJ May

Section

Case Report

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