[Carcinoma of the pararenal gland infiltrating the surrounding tissue and involving the inferior vena cava]. / Organüberschreitendes Nebennierenrindenkarzinom mit Beteiligung der Vena cava inferior.
Aktuelle Urol
; 44(5): 375-80, 2013 Sep.
Article
en De
| MEDLINE
| ID: mdl-24043537
UNLABELLED: â¼HISTORY AND ADMISSION FI NDINGS: A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites. INVESTIGATIONS: Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac -veins. TREATMENT AND COURSE: An open right adrenalectomy with resection of the periadrenal tissue and exstirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium - cardiac surgeon) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for 3 years. So far, no recurrence has occurred during a course of 7 years. CONCLUSION: Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive pararenal gland carcinoma.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vena Cava Inferior
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Neoplasias de la Corteza Suprarrenal
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Conducta Cooperativa
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Comunicación Interdisciplinaria
/
Células Neoplásicas Circulantes
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Female
/
Humans
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Middle aged
Idioma:
De
Revista:
Aktuelle Urol
Año:
2013
Tipo del documento:
Article
Pais de publicación:
Alemania