Anesthetic management of renal cell carcinoma with inferior vena caval extension.

We present a case of a patient with renal cell carcinoma extending into the inferior vena cava. Preoperative diagnosis was facilitated by transthoracic and transesophageal echocardiography (TEE), and inferior venacavography. Intraoperatively, monitoring with continuous TEE was used. Preparation was made for cardiopulmonary bypass but surgery was successfully completed using extracorporeal venous shunting. We discuss the important aspects of preoperative diagnosis and the intraoperative anesthetic management of this case.