A Death on surgical table due to renal tumor embolism : A Case Report

Abstract

This case report discusses the rare and fatal occurrence of pulmonary embolism caused by a renal cell carcinoma (RCC) tumor embolus during a nephrectomy in a 45-year-old male farmer from Sri Lanka. The patient presented with a left abdominal mass, loin pain, and painless hematuria, and was diagnosed with RCC, which had extended into the renal vein and inferior vena cava. Despite successful nephrectomy, the patient became hemodynamically unstable and suffered a cardiac arrest. Surgical exploration revealed a saddle thrombus obstructing the pulmonary trunk, which was consistent with a tumor embolus from the RCC. Despite resuscitation efforts, the patient died on the table. The autopsy confirmed the presence of clear cell carcinoma and identified the cause of death as pulmonary tumor embolism. This case highlights the rare yet fatal risk of tumor embolism during surgery for RCC and underscores the importance of medico-legal autopsy in determining the cause of death in such cases.