Pani S, et al. - Researchers undertook this retrospective and observational study to describe cases of renal cell carcinoma with inferior vena cava invasion, managed by surgical resection, and use of transesophageal echocardiogram (TEE). This study was performed at a single large university hospital and included 55 consecutive who had resection of renal cell carcinoma. In high grade tumors, cardiac anesthesiologists performed a transesophageal echocardiogram. Findings revealed the complex nature of surgical treatment of renal cell carcinoma with inferior vena cava tumor extension. Individualized treatment was needed in high-grade tumors. Collaboration between surgeons and anesthesiologists was needed to achieve successful outcomes. TEE evaluation and monitoring were beneficial in patients with level IIIb to IV tumor invasion, and may be life-saving, and involvement of cardiac anesthesia in those types of cases was recommended.