Volume 53, Issue 4, Pages (April 2008)

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Volume 53, Issue 4, Pages 845-848 (April 2008) Neoadjuvant Sutent Induction Therapy May Effectively Down-Stage Renal Cell Carcinoma Atrial Thrombi Pierre I. Karakiewicz, Nazareno Suardi, Claudio Jeldres, Pascale Audet, Pierre Ghosn, Jean-Jacques Patard, Paul Perrotte European Urology Volume 53, Issue 4, Pages 845-848 (April 2008) DOI: 10.1016/j.eururo.2007.11.006 Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 1 Pretreatment computed tomography scan demonstrates the left-sided primary tumor with a necrotic center and a massive renal vein and inferior vena cava thrombus with cephalad extension into the right atrium. European Urology 2008 53, 845-848DOI: (10.1016/j.eururo.2007.11.006) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 2 Cardiac echography demonstrating the protruding tumor thrombus within the right atrium. The broken axes demonstrate the dimension of the intra-atrial aspect of the thrombus, which measured 1×2cm. European Urology 2008 53, 845-848DOI: (10.1016/j.eururo.2007.11.006) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 3 A magnetic resonance image demonstrates the residual thrombus after two cycles of sunitinib. The thrombus consists of a solid component (dark filling defect at the ostium of the renal vein) and of a thin stalk that emanates from the proximal part of the renal vein. European Urology 2008 53, 845-848DOI: (10.1016/j.eururo.2007.11.006) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 4 Surgical specimen of the primary radical nephrectomy specimen and of the tumor thrombus. European Urology 2008 53, 845-848DOI: (10.1016/j.eururo.2007.11.006) Copyright © 2007 European Association of Urology Terms and Conditions