Intra-atrial tumor thrombus: an incidental finding during routine examination of a patient with moderate arterial hypertension


DOI: https://dx.doi.org/10.18565/therapy.2020.7.120-128

Alieva A.M., Batov M.A., Almazova I.I., Kovtyukh I.V., Reznik E.V., A.M. Rakhaev, Nikitin I.G.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, Moscow; 3) Central Clinical Hospital of the Russian Academy of Sciences, Moscow; 4) Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor of Russia, Nalchik
World statistics show that 90–95% of patients with kidney tumors are diagnosed with malignant neoplasms. Benign processes are much less common. Kidney cancer is the 10th most common malignant neoplasm worldwide. Mostly elderly men suffer from this disease. The tendency of renal cell carcinoma to spread in the form of a tumor thrombus along the renal and further along the inferior vena cava is one of the clinical characteristics of this cancer, noted with a frequency between 4 and 14%. This clinical feature of renal cell carcinoma is illustrated by the presented clinical case.
Keywords: kidney tumor, thrombosis, inferior vena cava, right atrium, computed tomography

Literature



  1. Bray F., Ferlay J., Soerjomataram I. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6): 394−424. doi:10.3322/caac.21492.

  2. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России. 2019; 250 с. Доступ: https://glavonco.ru/cancer_register/Забол_2018_Электр.pdf (дата обращения − 01.10.2020). [Malignant neoplasms in Russia in 2018 (morbidity and mortality). Ed. by Kaprin A.D., Starinsky V.V., Petrova G.V. M.: MNIOI im. P.A. Gertsena. 2019; 250 p. URL: https://glavonco.ru/cancer_register/Забол_2018_Электр.pdf (date of access − 01.10.2020) (In Russ.)].

  3. Siegel R.L., Miller K.D., Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017; 67(1): 7–30. doi:10.3322/caac.21387.

  4. Заридзе Д.Г., Мукерия А.Ф., Шаньгина О.В. Факторы риска почечно-клеточного рака. Сибирский онкологический журнал. 2018; 17(5): 77–86. [Zaridze D.G., Mukeria A.F., Shangina O.V. Risk factors for renal cell carcinoma. Sibirsky onkologichesky zhurnal. 2018; 17(5): 77–86 (In Russ.)]. doi: 10.21294/1814-4861-2018-17-5-77-86.

  5. Kay F.U., Pedrosa I. Imaging of solid renal masses. Radiol Clin North Am. 2017; 55(2): 243–58. doi: 10.1016/j.rcl.2016.10.003.

  6. Hegemann M., Kroeger N., Stenzl A., Bedke J. Rare and changeable as a chameleon: paraneoplastic syndromes in renal cell carcinoma. World J Urol. 2018; 36(6): 849–54. doi: 10.1007/s00345-018-2215-9.

  7. Камалов И.А., Абдрахманов Э.Ф., Зарипов Р.В. Опухолевые тромбы при раке почки. Поволжский онкологический вестник. 2017; 29(2): 67–77 [Kamalov I.A., Abdrakhmanov E.F., Zaripov R.V. The tumor thrombus in renal cancer. Povolzhsky onkologichesky vestnik. 2017; 29(2): 67–77 (In Russ.)].

  8. Ljungberg B., Albiges L., Abu-Ghanem Y. et al. European Association of Urology guidelines on renal cell carcinoma: The 2019 Update. Eur Urol. 2019; 75(5): 799–810. doi: 10.1016/j.eururo.2019.02.011.

  9. Pouliot F., Shuch B., Larochelle J.C. et al. Contemporary management of renal tumors with venous tumor thrombus. J Urol. 2010; 184(3): 833–1235. doi: 10.1016/j.juro.2010.04.071.

  10. Moch H., Cubilla A.L., Humphrey P.A. et al. The 2016 WHO classification of tumours of the urinary system and male genital organs – part A: renal, penile, and testicular tumours. Eur Urol. 2016; 70(1): 93–105. doi:10.1016/j.eururo.2016.02.029.

  11. Amin M.B., Edge S.B., Greene F.L. et al. eds. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017.

  12. Клинические рекомендации «Рак паренхимы почки». Общероссийский национальный союз «Ассоциация онкологов России». 2020; 105 с. Доступ: https://oncology-association.ru/files/clinical-guidelines-2020/rak_parenhimy_pochki.pdf (дата обращения − 01.10.2020). [Clinical guidelines «Kidney parenchyma cancer». Russian National Union «Association of Oncologists of Russia». 2020; 105 p. URL: https://oncology-association.ru/files/clinical-guidelines-2020/rak_parenhimy_pochki.pdf (date of access − 01.10.2020) (In Russ.)].

  13. Calderone C.E., Tuck B.C., Gray S.H. et al. The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus. Echocardiography. 2018; 35(12): 2047−55. doi:10.1111/echo.14187.

  14. Psutka S.P., Leibovich B.C. Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma. Ther Adv Urol. 2015; 7(4): 216−29. doi:10.1177/1756287215576443.


About the Autors


Amina M. Alieva, PhD, associate professor of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str. Tel.: +7 (906) 733-08-31. E-mail: amisha_alieva@mail.ru
Maksim A. Batov, student of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str. Tel.: +7 (926) 102-48-71.
E-mail: m.batov112@gmail.com. ORCID: 0000-0002-3780-4358
Ilda I. Almazova, doctor-teacher of National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane. Tel.: +7 (916) 903-94-83.
E-mail: almazovai@rambler.ru
Irina V. Kovtyukh, therapist, cardiologist of the highest qualification category, head of cardiologic Department of Central Clinical Hospital of the Russian Academy of Sciences. Address: 117593, Moscow, 1A Litovsky boulevard.
Tel.: +7 (906) 045-16-48
Elena V. Reznik, MD, professor of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str. Tel.: +7 (916) 380-39-23. E-mail: elenaresnik@gmail.com
Alik M. Rakhaev, MD, head of expert staff of Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor of Russia. Address: 360003, Nalchik, 131 Tarchokov Str. E-mail: alikrahaev@yandex.ru
Igor G. Nikitin, MD, professor, head of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str. Tel.: +7 (916) 161-57-27. E-mail: igor.nikitin.64@mail.ru


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