Giant metastatic intrapericardial tumor 20 years after nephrectomy

We present a rare case of giant, metastatic renal cell carcinoma of the pericardium diagnosed 20 years after nephrectomy. An endovascular procedure was used to place coils preoperatively in the large collateral vessels supplying the tumor to achieve mass reduction and reduce intraoperative bleeding. The tumor was resected through a median sternotomy, and the patient's recovery was uneventful. Preoperative coil placement in the tumoral arteries enabled a safe and bloodless resection in this rare presentation.