Revista chilena de cirugía
versión On-line ISSN 0718-4026
INNOCENTI C, FRANCO et al. Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case. Rev Chil Cir [online]. 2008, vol.60, n.2, pp.150-153. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262008000200012.
Renal angiomyolipoma is an uncommon benign tumor of mesenchymal origin. In less than five of 12 cases reported with renal vein and inferior vena cava involvement the thrombus extends to the right atrium. We report a 50 years old female with a left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart, invading the right atrium almost completely. The tumor was found during a study for abdominal pain. She underwent combined abdominal and cardiac surgery with pulmonary bypass. A left nephrectomy, cavotomy and intravascular dissection of the tumor were performed. The intravascular mass was pushed from abdomen and pulled out through the right atrium. Forty eight hours after surgery, she developed respiratory distress. A chest angio CT scan negative for pulmonary thromboembolism. However, anticoagulation with low molecular weight heparin was started due to the high risk for thromboembolism. She recovered, but 14 days after the original surgery, presented a massive hemoperitoneum. She was operated again, finding a diffuse oozing from the sites of previous dissection. The dose of anticoagulation was lowered, with a good postoperative evolution, being discharged 21 days later. After two years of follow up, she developed an incisional hernia that is repaired
Palabras clave : Angiomyolipoma; inferior vena cava; thromboembolism.