Samenvatting
Niercelcarcinoom is de meest voorkomende maligniteit van de nier. In 4-10% van de gevallen is er sprake van trombusingroei via de vena renalis in de vena cava inferior, in 1% tot in het rechter atrium. Symptomen kunnen hematurie of flankpijn zijn, maar zijn vaak atypisch of helemaal afwezig. In deze klinische les illustreren wij de verschillende presentaties van patiënten met niercelcarcinoom en tumortrombus in de vena cava. We benadrukken de noodzaak tot zorgvuldige preoperatieve planning, waarbij de uroloog, vaatchirurg en cardiothoracaal chirurg in nauw teamverband samen dienen te werken.
Summary
Case reports. Renal cell carcinoma with tumorthrombus in caval vein and right atrium
Renal cell carcinoma is the most common renal malignancy. Thrombus can grow into the renal vein and the caval vein in 4-10% of the cases, and even into the right atrium in 1%. Symptoms are haematuria and/or flank tenderness, although most symptoms are atypical or absent. In this clinical lesson we illustrate the various presentations of patients with renal cell carcinoma and central venous thrombus. We also emphasize the need of a careful pre-operative planning, in which the urologist, surgeon and cardiothoracic surgeon have to cooperate.
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* drs. J.G.H. Poerink, afdeling Urologie, nu werkzaam op afdeling Chirurgie, Martini Ziekenhuis, Groningen
dr. G.S.C. Geuzebroek, afdeling Vaatchirurgie
drs. K.W.H. Gisolf, afdeling Urologie
drs. T.L. de Kroon, afdeling Cardiothoracale chirurgie
drs. R.H.W. van de Mortel, afdeling Vaatchirurgie
dr. J. Wille, afdeling Vaatchirurgie
Alle auteurs zijn verbonden aan het St. Antonius ziekenhuis, Nieuwegein.
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Poerink, J., Geuzebroek, G., Gisolf, K. et al. Case reports. Niercelcarcinoom met tumortrombus in vena cava en rechter atrium. Tijdschrift voor Urologie 4, 125–129 (2014). https://doi.org/10.1007/s13629-014-0066-8
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DOI: https://doi.org/10.1007/s13629-014-0066-8