• Yaozhu Wang, Xu Wang, and Yuan Chang.
• Department of Anesthesiology, Shandong Provincial ENT Hospital, Shandong Provincial ENT Hospital affiliated to Shandong University.
• Medicine (Baltimore). 2020 Mar 1; 99 (11): e19392.

RationaleRenal carcinoma is a common malignant tumor of the urinary system, 4%-10% of which are complicated with tumor thrombi in the renal vein and the inferior vena cava; in about 1% of patients, the inferior vena cava tumor thrombus invades the right atrium. Surgery is the treatment of choice. Real-time monitoring with transesophageal echocardiography (TEE) has been widely used in various operations, including cardiac and non-cardiac operations for congenital heart diseases, coronary diseases, vascular heart diseases, and aorta diseases, etc. In this article, a case of a patient with right renal carcinoma complicated with an inferior vena cava tumor thrombus is reported.Patient ConcernsA 52-year-old man who was admitted to our hospital for lumbar pain lasting for one month.DiagnosisRight renal carcinoma complicated with an inferior vena cava tumor thrombus.InterventionsRadical nephrectomy of the renal carcinoma and removal of an inferior vena cava tumor thrombus under real-time monitoring with TEE were performed.OutcomesRadical nephrectomy was successfully performed within 5 minutes after the inferior vena cava was clamped, and then the inferior vena cava tumor thrombus was removed. On the second day after the operation, the patient's conditions improved; his consciousness was clear; he was transferred to a general ward. On the third day after the operation, the patient was able to get out of bed and was discharged on the sixth day after the operation.LessonsReal-time monitoring with TEE played an important role in many aspects in the radical nephrectomy of the renal carcinoma and removal of the inferior vena cava tumor thrombus.

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