关键词: 腔静脉瘤栓, 右侧心腔, 联合手术

Abstract: Objective Renal tumor and gynecological tumor invading into inferior vena cava and extending to the right cardiac cavities is rare,we report the experience of diagnosis and surgical treatment of intravenous tumor embolus extending through inferior vena cava into the right cardiac cavities. Methods From Junuary 2001 to May2008 ,4 patients with intravenous tumor embolus extending through inferior vena cava into the right cardiac cavities were treated stagedly in PUMCH .Three patients are leiomyomatosis. Two patients' operations were performed by stages, firstly removal of tumer in the right cardiac cavities was performed using cardiopulmonary bypass under mid - hypothermia, and ,postoperatively 3 - 4weeks, total abdominal hysterectomy with bilateral salpingo- oophorectomy including the tumor mass was performed. The other one patient's tumor were resected at one time.One patient is renal clear cell carcinoma, The urologist performed abdominal nephrectomy and then cardiac surgeon resect tumor embolus using cardiopulmonary bypass under deep hypothermic total circulatory. Results The four patients have uneventful recovery ,there was no death or any serious perioperative complications. Followed up of 3 months to 4 years showed no tumor recurrence after the operation, they are all survival. Conclusion Confirm diagnosis,the tumor embolus extending through inferior vena cava into the right cardiac cavities should be suspected among patients with renal cell carcinoma and multiple hysteromyoma.Successful therapy for intravenous tumor embolus is dependent on total one or two- stage surgical excision of the tumor and multi-department cooperation，and combined therapy.

Key words: intravenous tumor embolus, right heart, combined Surgery