[Multiple emboli from a cardiac metastasis of a renal-cell carcinoma]

A 68-year-old man was hospitalised with a vascular occlusion in the left leg. After treatment with urokinase he developed multiple intracerebral haemorrhages. The occlusion and the intracerebral haemorrhages evoked by urokinase were caused by embolisation originating from a cardiac metastasis of a renal-cell carcinoma. Cardiac surgery was performed, but complete removal of the tumour was not possible. The process of embolisation continued and the patient died a few weeks after diagnosis. Cardiac metastasis is seen in 10% of all cancer patients. Most of these metastases remain without symptoms. Left ventricular metastasis of renal-cell carcinoma without involvement of the inferior V. cava is very rare. If embolic occlusion of one or more vascular areas is present, transthoracic echography of the heart should be performed. Early detection and surgical treatment prevent further embolisation which may result in a better prognosis.