PMID- 22397783
OWN - NLM
STAT- MEDLINE
DCOM- 20121116
LR  - 20190608
IS  - 1677-6119 (Electronic)
IS  - 1677-5538 (Linking)
VI  - 38
IP  - 1
DP  - 2012 Jan-Feb
TI  - Retroperitoneal lymph node dissection with concomitant IVC thrombectomy, caval 
      wall resection, and grafting for metastatic NSGCT.
PG  - 135; discussion 136
AB  - INTRODUCTION: The management of a post-chemotherapy retroperitoneal mass 
      secondary to testicular cancer can present a surgical challenge when involving 
      adjacent organs or major vascular structures. We present the first video of a 
      retroperitoneal lymph node dissection (RPLND) with IVC (inferior vena cava) 
      thrombectomy, caval wall resection resulting from metastatic non-seminomatous 
      germ cell testis (NSGCT) cancer. METHODS: In this surgical video, we highlight 
      important surgical considerations in the management of a postchemotherapy 
      retroperitoneal mass with direct IVC wall invasion and level 2 thrombus in such a 
      patient. RESULTS: A 34 year old man underwent a right inguinal orchiectomy for a 
      mixed NSGCT (embryonal, yolk sac, and teratoma components) and elevated serum 
      tumor markers. He underwent systemic chemotherapy (BEP regimen x 4 cycles) with 
      subsequent near normalization of tumor markers. His post-chemotherapy imaging 
      revealed a 6 cm residual retroperitoneal mass with a level 2 IVC tumor thrombus 
      and suspected direct infrarenal IVC wall invasion from the mass. The patient 
      underwent an open post-chemotherapy RPLND, IVC thrombectomy, IVC resection and 
      grafting. The final pathology report of the retroperitoneal mass revealed 
      teratoma with no viable germ cell tumor elements and negative surgical margins. 
      His intra-operative and post-operative stages were unremarkable with his IVC 
      graft remaining patent and no evidence of disease recurrence at last follow-up. 
      CONCLUSION: We present the first surgical video of a post-chemotherapy RPLND with 
      IVC thrombectomy, caval wall resection and grafting for metastatic NSGCT. The 
      final pathology report of teratoma with no viable tumor highlights the local 
      vascular invasive potential of such pathology.
FAU - Hakky, Tariq
AU  - Hakky T
AD  - Department of Urology University of South Florida, Tampa, FL, USA.
FAU - Kim, Timothy
AU  - Kim T
FAU - Rodriguez, Alejandro R
AU  - Rodriguez AR
FAU - Armstrong, Paul
AU  - Armstrong P
FAU - Mangar, Devanand
AU  - Mangar D
FAU - Spiess, Philippe E
AU  - Spiess PE
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Video-Audio Media
PL  - Brazil
TA  - Int Braz J Urol
JT  - International braz j urol : official journal of the Brazilian Society of Urology
JID - 101158091
SB  - IM
MH  - Adult
MH  - Humans
MH  - Lymph Node Excision/*methods
MH  - Male
MH  - Retroperitoneal Neoplasms/*secondary/surgery
MH  - Retroperitoneal Space
MH  - Teratoma/*secondary/surgery
MH  - Testicular Neoplasms/*pathology
MH  - Thrombectomy/*methods
MH  - Tomography, X-Ray Computed
MH  - Vena Cava, Inferior/*surgery
EDAT- 2012/03/09 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/03/09 06:00
PHST- 2012/01/20 00:00 [accepted]
PHST- 2012/03/09 06:00 [entrez]
PHST- 2012/03/09 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - IBJUv38n1v1 [pii]
AID - 10.1590/s1677-55382012000100020 [doi]
PST - ppublish
SO  - Int Braz J Urol. 2012 Jan-Feb;38(1):135; discussion 136. doi: 
      10.1590/s1677-55382012000100020.