Prosthetic replacement of the inferior vena cava and common iliac veins in a child with locally advanced Wilms tumor complicated by tumor thrombosis
- Authors: Akhaladze D.G.1, Pavlushin P.M.2,3, Gramzin A.V.2,3, Tsyganok V.N.2, Kachanov D.Y.1, Gosteva K.V.2, Tatarintsev V.A.2, Grekov I.A.2
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Affiliations:
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
- State Novosibirsk Regional Clinical Hospital
- Novosibirsk State Medical University of Ministry of Healthcare of the Russian Federation
- Issue: Vol 22, No 4 (2023)
- Pages: 121-126
- Section: CLINICAL OBSERVATIONS
- Submitted: 28.08.2023
- Accepted: 17.10.2023
- Published: 20.12.2023
- URL: https://hemoncim.com/jour/article/view/754
- DOI: https://doi.org/10.24287/1726-1708-2023-22-4-121-126
- ID: 754
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Abstract
Tumor thrombosis of the inferior vena cava in children with nephroblastoma is a relatively rare complication that requires a multimodal approach to treatment and involves many specialists. This condition occurs in 10% of children with Wilms tumor but cases when a tumor thrombus extends to the orifices of the hepatic veins and more cranially, are much less common. In most patients, neoadjuvant chemotherapy can significantly reduce the size of a tumor thrombus, which may eliminate the need for revision surgery of the inferior vena cava. Due to the rarity of this clinical condition, the optimal surgical strategy for tumor thrombosis of the inferior vena cava in children has not been fully defined yet. Here, we present a clinical case of a child with locally advanced stage 4 Wilms tumor of the right kidney and tumor thrombosis of the inferior vena cava that extended mostly in the caudal direction, to the confluence of the iliac veins. The patient received 6 weeks of neoadjuvant therapy with AVD (actinomycin D, vincristine, doxorubicin) and underwent nephrectomy for local control, with prosthetic replacement of the terminal sections of the common iliac veins as well as of the inferior vena cava up to its subhepatic segment, and implantation of the left renal vein. In the early postoperative period, the child developed thrombosis of the prosthesis, without hemodynamically significant abnormalities. At the time of writing, the patient had been followed up for 12 months and was considered to be in remission. The patient’s parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.
About the authors
D. G. Akhaladze
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: d.g.akhaladze@gmail.com
ORCID iD: 0000-0002-1387-209X
SPIN-code: 6893-6854
Dmitry G. Akhaladze, Dr. Med. Sci., Head of Thoracoabdominal Surgery Group
1 Samory Mashela St., Moscow 117997
Russian FederationP. M. Pavlushin
State Novosibirsk Regional Clinical Hospital;Novosibirsk State Medical University of Ministry of Healthcare of the Russian Federation
ORCID iD: 0000-0002-6684-5423
Novosibirsk
Russian FederationA. V. Gramzin
State Novosibirsk Regional Clinical Hospital;Novosibirsk State Medical University of Ministry of Healthcare of the Russian Federation
ORCID iD: 0000-0001-7338-7275
Novosibirsk
Russian FederationV. N. Tsyganok
State Novosibirsk Regional Clinical Hospital
ORCID iD: 0000-0003-1176-6741
Novosibirsk
Russian FederationD. Yu. Kachanov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
ORCID iD: 0000-0002-3704-8783
Moscow
Russian FederationK. V. Gosteva
State Novosibirsk Regional Clinical Hospital
Novosibirsk
Russian FederationV. A. Tatarintsev
State Novosibirsk Regional Clinical Hospital
ORCID iD: 0009-0001-0415-1397
Novosibirsk
Russian FederationI. A. Grekov
State Novosibirsk Regional Clinical Hospital
ORCID iD: 0009-0009-8352-7943
Novosibirsk
Russian FederationReferences
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