Mysuru: Manipal Hospital, Mysuru, recently created awareness on a complex case of kidney cancer along with a massive tumour thrombus involving inferior vena cava in a septuagenarian patient.

Addressing a press conference at Pathrakartara Bhavan in city, the doctors said this rare and challenging case required a multidisciplinary approach, giving a new lease of life to patient.

The case: Chandru (name changed), a 71-year-old resident of Mysuru, reached out to Dr. T. P. Dinesh Kumar, Consultant – Urology, Andrology and Kidney Transplant Surgeon at Manipal Hospital, Mysuru, with symptoms like blood in the urine, medically called haematuria, and significant weight loss over the last two months.

He had a known history of hypertension and COPD. Upon examination, a palpable mass was identified in the right flank region. Ultrasound and CT urogram revealed Renal Cell Carcinoma, stage-3, a 12 cm renal mass on the right side,  with a tumour thrombus extending into the right renal vein — inferior vena cava (IVC), along with the involvement of aortocaval lymph nodes.

Renal cell carcinoma is the most common type of kidney cancer in adults, originating in the lining of  the proximal convoluted tubule. While most cases are confined to the kidney, about 4% of patients experience a rare and aggressive form where the tumour extends beyond the kidney into the inferior vena cava, a large vein that carries deoxygenated blood from the lower and middle body to the heart.

Using a multidisciplinary approach, a team of expert surgeons led by Dr. Dinesh Kumar along with Dr. Upendra Shenoy, Consultant – Cardiothoracic and Vascular Surgery, Dr. H. Vasudeva Pai, Consultant – Surgical Gastroenterology and a skilled team of anaesthetists and intensivists, successfully performed a Right Radical Nephrectomy and IVC Thrombectomy to remove the entire kidney tumour.

Dr. Dinesh Kumar noted, “This was a highly challenging case due to the advanced stage of cancer and the involvement of inferior vena cava, making the surgery highly complex and risky. Our team had to work with precision to control bleeding and ensure the patient’s safety.”

Post-surgery, Chandru was monitored in the ICU and discharged after five days. His hematuria resolved and he has shown significant recovery, gaining weight and maintaining clear urine. After a seven-month follow-up, he remains in good health with a PET scan showing no signs of residual cancer.

Currently, Chandru is undergoing immunotherapy to prevent the risk of recurrence.