Laparoscopic Vena Cava Thrombectomy and Radical Nephrectomy in a Malignant Pheochromocytoma Case

Tito Palmela Palmela Leitão

doi:10.24915/aup.37.1-2.162

Autores

Tito Palmela Palmela Leitão Univerdade de Lisboa - Faculdade de Medicina http://orcid.org/0000-0002-0075-6196
Centro Hospitalar Universitário Lisboa Norte https://orcid.org/0000-0002-5179-4491
Centro Hospitalar Universitário Lisboa Norte http://orcid.org/0000-0003-3196-1886
Centro Hospitalar Universitário Lisboa Norte
Centro Hospitalar Universitário Lisboa Norte
Univerdade de Lisboa - Faculdade de Medicina
Univerdade de Lisboa - Faculdade de Medicina
Univerdade de Lisboa - Faculdade de Medicina
Univerdade de Lisboa - Faculdade de Medicina https://orcid.org/0000-0002-4782-7318
Univerdade de Lisboa - Faculdade de Medicina
Univerdade de Lisboa - Faculdade de Medicina

DOI:

https://doi.org/10.24915/aup.37.1-2.162

Palavras-chave:

Feocromocitoma, Laparoscopia, Nefrectomia, Procedimentos Cirúrgicos Robóticos, Trombectomia, Veia Cava Inferior

Resumo

Os feocromocitomas com trombo na veia cava são entidades extremamente raras, estando poucos casos descritos na literatura. Apesar da nefrectomia radical com adrenalectomia/suprarrenalectomia e trombectomia da veia cava inferior (VCI) corresponder ao tratamento de escolha, esta é uma técnica cirúrgica desafiante com uma abordagem ainda não padronizada. Apresenta-se um caso de um homem de 49 anos com diagnóstico incidental de um feocromocitoma localmente invasivo, com trombo na VCI nível 1. Foi proposta uma nefrectomia radical direita laparoscópica com adrenalectomia/suprarrenalectomia, trombectomia da VCI e cavorrafia. Neste artigo faz-se uma descrição detalhada da técnica cirúrgica e uma comparação com as estratégias atualmente utilizadas no tratamento do feocromocitoma. Tumores renais e suprarrenais/adrenais com trombo na veia cava estão associados a maior morbilidade e mortalidade, sobretudo no caso do feocromocitoma. Apesar de complexa, a cirurgia minimamente invasiva é uma opção segura no contexto de uma equipa experiente e multidisciplinar.

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Biografia Autor

Tito Palmela Palmela Leitão, Univerdade de Lisboa - Faculdade de Medicina

Urology

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Nefrectomia Radical com Trombectomia da Veia Cava Laparoscópica num Caso de Feocromocitoma Maligno