Breaking down tumor thrombus: Current strategies for medical management

Thromb Res. 2023 Oct:230:144-151. doi: 10.1016/j.thromres.2023.09.004. Epub 2023 Sep 13.

Abstract

Tumor thrombus, the intravascular extension of tumor into adjacent blood vessels, is frequently encountered in patients with renal cell carcinoma and hepatocellular carcinoma, and often involves the abdominal vasculature including the renal vein, portal vein, and the inferior vena cava. While a bland thrombus is composed of platelets and fibrin, in contrast, a tumor thrombus refers to an organized collection of tumor cells. Though oftentimes detected incidentally on imaging, tumor thrombus may have significant clinical implications and can be challenging to differentiate from bland thrombus. Additionally, the optimal management of tumor thrombus, including the use of anticoagulation, remains poorly described. This review summarizes common causes of tumor thrombus, as well as its impact on staging, prognosis, and treatment.

Keywords: Anticoagulation; Bland thrombus; Cancer; Prognosis; Thrombosis; Tumor thrombus; Venous tumor thrombus.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell* / pathology
  • Carcinoma, Renal Cell* / surgery
  • Humans
  • Kidney Neoplasms* / pathology
  • Kidney Neoplasms* / surgery
  • Nephrectomy / methods
  • Retrospective Studies
  • Thrombosis* / pathology
  • Vena Cava, Inferior / pathology