<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> Renal cell carcinoma has a propensity to propagate into the renal vein and inferior vena cava. A small percentage has distant metastasis at presentation. Pulmonary, hepatic, cerebral and bone metastases are common, but skeletal muscle involvement is rare.<bold>Case presentation:</bold> We present the case of a 51-year-old patient complaining of right flank pain, gross hematuria and a painful left laterothoracic mass. Preoperative examination revealed a tumor in the inferior pole of the right kidney, thrombosis of the right renal vein that extended into the inferior vena cava and a left laterothoracic tumor. We decided on a preoperative digital subtraction angiography and selected embolization of the laterothoracic mass. We performed right radical nephrectomy with vena cava thrombus excision and excision of the left laterothoracic tumor. The pathological examination revealed a clear cell renal carcinoma with sarcomatoid differentiation of the right kidney. Metastases with the above features were noticed in the right adrenal gland and in the skeletal muscle of the chest wall.<bold>Conclusions:</bold> The surgical resection of large renal tumors with associated thrombus within the inferior vena cava is challenging to any surgeon. The preoperative embolization of the metastatic tumor is helpful in the reduction of pain and intraoperative blood loss.</abstract>

Introduction: Renal cell carcinoma has a propensity to propagate into the renal vein and inferior vena cava. A small percentage has distant metastasis at presentation. Pulmonary, hepatic, cerebral and bone metastases are common, but skeletal muscle involvement is rare.Case presentation: We present the case of a 51-year-old patient complaining of right flank pain, gross hematuria and a painful left laterothoracic mass. Preoperative examination revealed a tumor in the inferior pole of the right kidney, thrombosis of the right renal vein that extended into the inferior vena cava and a left laterothoracic tumor. We decided on a preoperative digital subtraction angiography and selected embolization of the laterothoracic mass. We performed right radical nephrectomy with vena cava thrombus excision and excision of the left laterothoracic tumor. The pathological examination revealed a clear cell renal carcinoma with sarcomatoid differentiation of the right kidney. Metastases with the above features were noticed in the right adrenal gland and in the skeletal muscle of the chest wall.Conclusions: The surgical resection of large renal tumors with associated thrombus within the inferior vena cava is challenging to any surgeon. The preoperative embolization of the metastatic tumor is helpful in the reduction of pain and intraoperative blood loss.

Skeletal Muscle Metastases and Inferior Vena Cava Involvement in a Patient with Clear Cell Renal Cell Carcinoma and Sarcomatoid Differentiation

Surgery Clinic No. I, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Clinic of Urology, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Department of Radiology, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Department of Pathology, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Journal of Interdisciplinary Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction: Renal cell carcinoma has a propensity to propagate into the renal vein and inferior vena cava. A small percentage has distant metastasis at...

Skeletal Muscle Metastases and Inferior Vena Cava Involvement in a Patient with Clear Cell Renal Cell Carcinoma and Sarcomatoid Differentiation

Published Online: Oct 23, 2016

Page range: 197 - 200

Received: Jul 31, 2016

Accepted: Sep 01, 2016

DOI: https://doi.org/10.1515/jim-2016-0039

Keywords
inferior vena cava thrombosis, renal vein thrombosis, sarcomatoid clear cell renal cell carcinoma, skeletal muscle metastasis

© 2016 Călin Molnar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Skeletal Muscle Metastases and Inferior Vena Cava Involvement in a Patient with Clear Cell Renal Cell Carcinoma and Sarcomatoid Differentiation

Published Online: Oct 23, 2016

Page range: 197 - 200

Received: Jul 31, 2016

Accepted: Sep 01, 2016

DOI: https://doi.org/10.1515/jim-2016-0039

Keywordsinferior vena cava thrombosis, renal vein thrombosis, sarcomatoid clear cell renal cell carcinoma, skeletal muscle metastasis

© 2016 Călin Molnar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
inferior vena cava thrombosis, renal vein thrombosis, sarcomatoid clear cell renal cell carcinoma, skeletal muscle metastasis