Treatment Sequencing in Renal Ewing's Sarcoma With Inferior Vena Cava (IVC) Thrombus: A Comparative Case-Based Analysis.
- 1Department of Urology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
- 2Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Abstract
Renal Ewing's sarcoma with inferior vena cava (IVC) tumour thrombus is a rare and aggressive malignancy that may mimic renal cell carcinoma (RCC) on imaging, creating diagnostic and therapeutic challenges. We report two young female patients presenting with large renal masses and level II IVC tumour thrombus who were managed using contrasting treatment sequences. In the first patient, image-guided biopsy established the diagnosis, allowing neoadjuvant systemic chemotherapy that resulted in substantial tumour and thrombus downsizing and facilitated subsequent surgical resection. In the second patient, persistent haematuria and progressive anaemia prompted urgent upfront surgery, which was followed by significant postoperative morbidity and delayed initiation of systemic chemotherapy. These contrasting cases highlight the potential value of early tissue diagnosis in selected clinically stable patients with atypical renal masses and emphasise that treatment sequencing should be individualised according to clinical status, tumour extent, thrombus burden, and multidisciplinary assessment.
Related
- Response to comments on “Robotic surgical techniques and methods for treating renal cell carcinoma with inferior vena cava tumor thrombus”
- Dramatic and sustained regression of an inferior vena cava tumor thrombus in a patient with unresectable giant hepatocellular carcinoma following sequential systemic therapy: a case report and literature review
- Comparative and Histology-Aware Bioinformatic Characterization of FAM171A1 and FAM171A2 in Sarcoma: Expression, Prognostic, and Immune Associations
- Cancer-associated stroke: a comparative analysis of thrombus composition, resistance to lysis, and plasma biomarkers
- SERPINC1-mediated hereditary antithrombin deficiency with refractory pulmonary embolism: successful treatment with VA-ECMO and interventional thrombus aspiration
BibTeX
@article{navriya2026treatment,
title = {{Treatment Sequencing in Renal Ewing's Sarcoma With Inferior Vena Cava (IVC) Thrombus: A Comparative Case-Based Analysis.}},
author = {Shiv Charan Navriya and Aquib Javed M Patel and Jitendra S Rathor and Gautam Choudhary and Sudeep Khera and Aasma Nalwa and Arjun S Sandhu},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116439},
url = {https://europepmc.org/article/MED/42910229},
note = {CC BY},
}
RIS
TY - JOUR
TI - Treatment Sequencing in Renal Ewing's Sarcoma With Inferior Vena Cava (IVC) Thrombus: A Comparative Case-Based Analysis.
AU - Shiv Charan Navriya
AU - Aquib Javed M Patel
AU - Jitendra S Rathor
AU - Gautam Choudhary
AU - Sudeep Khera
AU - Aasma Nalwa
AU - Arjun S Sandhu
PY - 2026
DA - 2026/09/17
JO - Cureus
DO - 10.7759/cureus.116439
UR - https://europepmc.org/article/MED/42910229
AB - Renal Ewing's sarcoma with inferior vena cava (IVC) tumour thrombus is a rare and aggressive malignancy that may mimic renal cell carcinoma (RCC) on imaging, creating diagnostic and therapeutic challenges. We report two young female patients presenting with large renal masses and level II IVC tumour thrombus who were managed using contrasting treatment sequences. In the first patient, image-guided biopsy established the diagnosis, allowing neoadjuvant systemic chemotherapy that resulted in substantial tumour and thrombus downsizing and facilitated subsequent surgical resection. In the second patient, persistent haematuria and progressive anaemia prompted urgent upfront surgery, which was followed by significant postoperative morbidity and delayed initiation of systemic chemotherapy. These contrasting cases highlight the potential value of early tissue diagnosis in selected clinically stable patients with atypical renal masses and emphasise that treatment sequencing should be individualised according to clinical status, tumour extent, thrombus burden, and multidisciplinary assessment.
SN - 2168-8184
ER -