Migration of a tumor thrombus promptly detected by transesophageal echocardiography during radical nephrectomy concomitant with inferior vena cava thrombectomy: a case report

Abstract

Corresponding author Jun-Young Park Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-1415 Fax: +82-2-3010-6790 E-mail: parkjy@amc.seoul.kr ORCID: http://orcid.org/0000-0003-4476-4945 A 60-year-old man with a 12 cm mass involving the right kidney and a renal vein tumor thrombus extending to the intrahepatic inferior vena cava (IVC), was scheduled for a radical nephrectomy concomitant with an IVC thrombectomy. During the operation, through intraoperative transesophageal echocardiography (TEE) monitoring, a migrating tumor thrombus was promptly detected. After the operation, a filling defect in the posterior basal segmental or subsegmental pulmonary arteries of the lower lobe of the right lung was observed on chest computed tomography. Intraoperative TEE provides additional information to help guide the surgical intervention and medical treatment.