Surgery for Pediatric Renal Malignancy With Cavoatrial Extension

Nakahara Yasuo, Goto Takafumi, Iwamura Yoshinobu, Takahashi Yusuke, Asai Takeshi, Usui Hidehito, Aoyama Koji

doi:10.11164/jjsps.47.3_345

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Other Title

下大静脈腫瘍進展を認めた小児腎悪性腫瘍に対する手術
症例報告下大静脈腫瘍進展を認めた小児腎悪性腫瘍に対する手術
ショウレイホウコクシタダイジョウミャクシュヨウシンテンオミトメタショウニジンアクセイシュヨウニタイスルシュジュツ

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Abstract

The treatment strategy for pediatric renal malignancy with cavoatrial extension is still controversial. We have treated four cases in the last twenty years. Case 1 was stage III nephroblastoma with intracardiac tumor extension and the tumor was resected under cardiopulmonary bypass with hypothermic circulatory arrest. Case 2 was stage IV nephroblastoma with inferior vena caval extension and the tumor was resected by side clamping of the inferior vena cava after neoadjuvant chemotherapy. Case 3 was stage IV MRTK with intracardiac tumor extension and the tumor was resected under cardiopulmonary bypass after neoadjuvant chemotherapy. Case 4 was stage IV nephroblastoma with intracaval extension and the tumor was resected with partial combined resection of the inferior vena cava after neoadjuvant chemotherapy and radiotherapy. The three cases other than case 3 are still alive and disease free. It seems important to investigate the extent of tumor thrombus adequately initially and an appropriate procedure should be chosen depending on the extent of tumor thrombus after neoadjuvant chemotherapy.

Journal

Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 47 (3), 345-349, 2011

The Japanese Society of Pediatric Surgeons

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