Surgery for tumors with cavoatrial extension.

Intracardiac extension of infradiaphragmatic tumors is an uncommon but significant surgical challenge for the treating surgeon. Renal cell carcinoma is the most common malignant tumor seen, with Wilms' tumor, uterine tumors (both benign and malignant), adrenal tumors, hepatoma, and lymphoma less frequently encountered. Surgical resection requires involvement of a cardiothoracic surgeon, urologist, and/or gynecologist. Cardiopulmonary bypass and deep hypothermic circulatory arrest provide the safest and most effective technique for removing these tumors.