Surgical excision of renal cell carcinoma with caval and intra-atrial tumour thrombus extension using deep hypothermic circulatory arrest

Surgery for tumour thrombus extension in Renal Cell Carcinoma may be associated with a good prognosis if no distant metastases are identified and if the thrombus can be completely excised. The surgical approach chosen will depend on the level of tumour thrombus extension. We present a case of Renal Cell Carcinoma in the right kidney with tumour thrombus extension into the right atrium. This was successfully removed by right radical nephrectomy and excision of the atrial thrombus using cardio-pulmonary bypass and deep hypothermic circulatory arrest. This is the first procedure of its kind to be undertaken in Malta.