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Release of the Inferior Vena Cava Ligament during Caval Thrombectomy Causing Tumor Thrombus Embolization

Joshi S.a · Gorin M.A.e · Ciancio G.a-d
aMiami Transplant Institute, Departments of bUrology and cSurgery, University of Miami Miller School of Medicine, and dJackson Memorial Hospital, Miami, Fla.; eJames Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Md., USA Urol Int 2013;90:490-492 (DOI:10.1159/000346412)


Intraoperative tumor embolization is a rare complication during the surgical management of renal cell carcinoma with tumor thrombus of the inferior vena cava (IVC). We present a case of pulmonary tumor embolism which occurred during liver mobilization immediately following division of the IVC ligament. We hypothesize that this patient's IVC ligament acted as an external barrier to propagation of the tumor thrombus and that its release caused the tumor to rapidly expand leading to embolization. To our knowledge, this is the first report of a pulmonary tumor embolism occurring immediately following division of the IVC ligament.


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