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在下腔静脉中形成瘤栓是某些肾与肾上腺肿瘤的特点,偶尔瘤栓可延至右心房,这一并发症文献报告占肾肿瘤1～4％。瘤栓切除可延长生存期,也有未经任何治疗生存五年半的病例。作者报告2例肾上腺皮质癌,1例肾细胞癌心房蔓延的病例。例1:女性18岁,闭经18月,面部与体表毛发增激素与血清皮质醇显著增高,腹部CT扫描见右肾上腺有一肿块。术中见右肾上腺有一直径12cm肿瘤,瘤栓蔓延到下腔静脉达膈水平,打开心包,见右心房存在瘤栓。在没有心肺分流下,行心房切开术和腔静脉切开术,摘除癌栓,并完全切除肾上腺肿瘤
The formation of tumor thrombi in the inferior vena cava is a feature of certain renal and adrenal tumors. Occasionally, the tumor thrombus can be extended to the right atrium. This complication has been reported in the literature as accounting for 1-4% of renal tumors. The tumor thrombectomy can prolong the survival period, and there are also cases that have survived without treatment for five and a half years. The authors report two cases of adrenocortical carcinoma and one case of atrial spread of renal cell carcinoma. Example 1: 18-year-old female, 18 months of amenorrhea, facial and body hair hormone and serum cortisol significantly increased, abdominal CT scan showed a lump in the right adrenal gland. During the operation, the right adrenal gland had a tumor with a diameter of 12 cm. The tumor thrombus spread to the inferior vena cava and reached the fistula level. The pericardium was opened and the tumor thrombus was seen in the right atrium. In the absence of cardiopulmonary bypass, atrial and vena cavaotomy were performed, tumor thrombectomy was removed, and complete adrenal tumor resection was performed.