Atrial Metastasis of Renal Cell Carcinoma: A Rare Presentation

Abstract

Renal cell carcinoma (RCC) is an aggressive and lethal tumor that has a high frequency of metastatic spread to unpredictable sites. One quarter of patients have either distant metastases or significant local-regional disease with atypical symptoms on presentation. We present a 41-year-old patient with symptoms of right heart failure and was found to have metastatic renal cell carcinoma with enhancing tumor from left renal vein up to right atrium.

Renal Cell Carcinoma with Right Ventricular Metastatic Spread: An Unusual Finding with Poor Prognosis

“…5 The long-term prognosis is poor for those who have been diagnosed with metastatic RCC, with life usually limited to months despite treatment with surgery and immunotherapy. 1,2,12 The benefit of anticoagulation therapy in these patients in unclear. It is recommended that patients who have pure thrombus in addition to thrombus/tumor combination should undergo anticoagulation.…”

“… 5 The long-term prognosis is poor for those who have been diagnosed with metastatic RCC, with life usually limited to months despite treatment with surgery and immunotherapy. 1 , 2 , 12 …”

“…Renal cell carcinoma (RCC), the most common form of kidney cancer, is known to be an aggressive disease and accounts for 3% of all adult malignancies. 1 , 2 Predisposing risk factors include obesity, smoking, hypertension, polycystic kidney disease, and male sex, with a peak incidence in the sixth and seventh decades of life. The typical presentation of hematuria, abdominal mass, and flank pain is rare and is usually associated with advanced disease.…”

Metastatic renal cell carcinoma complicated by right atrial thrombus

“…Kidney cancer constitutes about 3% of all malignancies in the adult population. 1 It is the 7th most common cancer in men and the 10th most common cancer in women. 2 More than 400 000 new cases of renal cell carcinoma (RCC) were reported globally in 2018.…”

“…6 RCC is associated with coagulopathy and development of inferior vena cava (IVC) thrombus in 4%-10% of cases, with approximately only 1% extending into the right atrium. 1 Metastasis is common to the lungs, liver, lymph nodes, brain, bones, and a significant predictor of prognosis in RCC. 7 With the increasing use of imaging, more than 70% of all RCC being diagnosed as an incidental finding on imaging studies.…”