# Treatment of renal leiomyosarcoma with right atrial tumor embolus without cardiopulmonary bypass: a case report

## TL;DR

A rare case of kidney leiomyosarcoma with a tumor embolus in the right atrium was successfully treated with surgery and chemotherapy.

## Contribution

This case report provides surgical experience for treating grade IV tumor thrombus without cardiopulmonary bypass.

## Key findings

- Radical resection of the kidney and tumor thrombus was achieved without cardiopulmonary bypass.
- Postoperative pathology confirmed leiomyosarcoma with no cancer at the ureter incision.
- The case highlights the rarity and high malignancy of primary renal leiomyosarcoma with right atrial embolus.

## Abstract

To investigate the clinical manifestations, imaging and pathological features, treatment methods and prognosis of primary leiomyosarcoma of kidney, and the choice of treatment with tumor thrombus.

The clinical data of a patient with primary renal leiomyosarcoma complicated with inferior vena cava and right atrial tumor thrombus were retrospectively analyzed. Radical resection of right kidney without cardiopulmonary bypass and removal of inferior vena cava and right atrial tumor thrombus were performed. Adjuvant intravenous chemotherapy was given according to the results, and follow-up observation was made.

Postoperative pathological findings were: leiomyosarcoma (right renal tumor), the size of the mass was about 12.1 cm, and no cancer was found at the incision end of the right ureter.

Primary leiomyosarcoma of kidney is rare in clinical practice, and complication of right atrial tumor embolus is even rarer. The disease has high malignant degree and poor prognosis. The clinical manifestations and imaging examinations were non-specific, and pathological diagnosis was the gold standard. Radical surgical resection is the main treatment method at present, and it provides experience for the treatment of grade IV tumor thrombus without cardiopulmonary bypass.