Metastatic Renal Cell Carcinoma

Vogel, Richard I.; Balady, Gary J.; Klein, Michael D.; Rajaii-Khorasani, Ahmad

doi:10.1378/chest.98.2.481

Cited by 15 publications

(3 citation statements)

References 6 publications

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“…In metastatic lung tumors, there have been some reports of tumor thrombus in the pulmonary vein. Most of them were metastatic lung tumors from HCC, renal cell carcinoma (RCC), and sarcoma [ 4 , 10 – 13 ]. These malignant tumors have been reported to develop a tumor thrombus in the great vessels, such as the inferior vena cava, in primary lesions [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report

Ohtaka

Ohtake

Ishii

et al. 2023

J Cardiothorac Surg

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Background Metastatic lung tumor with a tumor thrombus in the peripheral pulmonary vein is very rare. We present a case of a metastatic lung tumor from hepatocellular carcinoma (HCC) with tumor thrombus invasion in the pulmonary vein that was diagnosed preoperatively and underwent complete resection by segmentectomy. Case presentation A 77-year-old man underwent laparoscopic lateral segment hepatectomy for HCC eight years ago. Protein induced by vitamin K absence or antagonist-II remained elevated from two years ago. Contrast-enhanced chest computed-tomography (CT) showed a 27 mm nodule in the right apical segment (S1). He was pathologically diagnosed with a metastatic lung tumor from HCC via transbronchoscopic biopsy. We planned to perform right S1 segmentectomy. Before surgery, contrast-enhanced CT in the pulmonary vessels phase for three-dimensional reconstruction showed that the tumor extended into the adjusting peripheral pulmonary vein, and we diagnosed tumor thrombus invasion in V1a. The surgery was conducted under 3-port video-assisted thoracic surgery. First, V1 was ligated and cut. A1 and B1 were cut. The intersegmental plane was cut with mechanical staplers. Pathological examination revealed moderately-differentiated metastatic HCC with tumor thrombus invasions in many pulmonary veins, including V1a. No additional postoperative treatments were performed. Conclusions As malignant tumors tend to develop a tumor thrombus in the primary tumor, it might be necessary to perform contrast-enhanced CT in the pulmonary vessel phase to check for a tumor thrombus before the operation for metastatic lung tumors.

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Section: Discussionmentioning

confidence: 99%

Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report

Ohtaka

Ohtake

Ishii

et al. 2023

J Cardiothorac Surg

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“…Due to the risk of sudden death, embolism, and intraoperative or perioperative events in every patient with an intracardiac mass (11), it is wise to seek a cardiovascular or cardiothoracic surgery consult in such patients before any other intervention. Myxoma will be suspected first as it is the most common primary cardiac tumor (5). In fact, in the biopsy of 266 patients with cardiac masses, only 1.1% were RCC (13).…”

Section: Discussionmentioning

confidence: 99%

“…On review of literature, except the present case, all the previously reported cases of LA metastasis from RCC revealed pulmonary veins involvement. Apart from the report by Miyamoto et al (6) where a direct invasion of pulmonary vein from a mediastinal lymph node was confirmed, most reports mentioned the lung as the source of pulmonary vein, and LA metastasis (4, 5, 7, 8), or could not rule out such source (9). While previous reports may apparently suggest a hypothesis that all LA metastases from RCC occur via pulmonary veins (although the small sample size cannot allow to draw further conclusions), the coronary sinus invasion in the present case and the absence of pulmonary vein tumor thrombus may raise a suspicion of another pathway in which LA metastasis can occur via coronary sinus—coronary sinus tumor thrombus invading the LA.…”

Section: Discussionmentioning

confidence: 99%

Renal Cell Carcinoma Metastasizing to Left Atrium With Coronary Sinus Invasion: A Rare Site of Metastasis Mimicking Myxoma

et al. 2019

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Renal cell carcinoma (RCC) metastasizing to the heart with inferior vena cava (IVC) involvement is well-documented. However, its metastasis to the right heart without venous involvement is very rare. To the left atrium, metastasis is even rarer with only a few cases reported in medical literature. Herein, we report a case of a 56-year-old man who presented to our department for the treatment of a right renal mass and a right adrenal mass discovered on a follow-up plain computed tomography (CT) 13 years after left laparoscopic radical nephrectomy. During the workup, a transthoracic echocardiography (TTE) revealed a left atrial mass with a suspicion of a myxoma. This finding prompted a cardiac surgery consult which proposed a surgical removal of the mass. Intraoperatively, the tumor was found to invade the coronary sinus as well. The entire tumor was successfully removed and surgical repair of the unroofed coronary sinus was performed. Pathological examination of the tumor along with immunohistochemistry–showing positivity for CAIX, CD10, Vimentin, and PAX-8–pointed to a diagnosis of metastatic clear cell RCC. Eight months postoperatively, he was free of any symptom. In conclusion, RCC metastasizing to the left atrium is extremely rare. A comprehensive search revealed only nine reports in the literature. We report, to our knowledge, the first case of RCC metastasizing to the left atrium with concomitant invasion of coronary sinus. Surgical resection combined with unroofed coronary sinus repair allowed a complete removal of the tumor. In patients with a history of RCC, a metastasis should be thought of when a left atrial mass is present.

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Metastases from Cancers of the Urogenital Tract

TxNxM1

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Metastatic Renal Cell Carcinoma

Cited by 15 publications

References 6 publications

Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report

Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report

Renal Cell Carcinoma Metastasizing to Left Atrium With Coronary Sinus Invasion: A Rare Site of Metastasis Mimicking Myxoma

Metastases from Cancers of the Urogenital Tract

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