Pediatric clear cell sarcoma of the kidney with atriocaval thrombus |
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Authors: | Mehran Hiradfar Nona Zabolinejad Reza Shojaeian Parisa Saeedi Marjan Joodi Reza Nazarzadeh Hamid Farhangi Mohammad Abbasi Tashnizi Seyed Ali Alamdaran |
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Affiliation: | 1. Mashhad Medical University, Mashhad, Khorasan, Islamic Republic of Iran
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Abstract: | Clear cell sarcoma of the kidney (CCSK) is an uncommon neoplasm that accounts for almost 3?% of pediatric renal tumors. Cavoatrial tumor thrombosis is very rare and because of poor response to chemotherapy, invasive surgical interventions such as open heart surgery may be indicated. A 6-year-old girl with CCSK of right kidney was treated with neoadjuvant chemotherapy. According to poor chemosensitivity, surgical intervention was planned. Right atriotomy was done, but intra-atrial part of tumor was very firm and unsuctionable; so the procedure was completed by laparotomy and en bloc resection of tumoral kidney and its cavoatrial extension through a limited venotomy on inferior vena cava. Although radical resection of CCSK with intracaval involvement should be considered as a multidisciplinary approach and intensive care and supports should be provided, atriocaval tumor in growth in CCSK is firm, non friable and non-adherent, and tumor en bloc resection may be possible through a limited venotomy via primary abdominal approach. |
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