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Renal Cell Carcinoma Isolated to the Left Ventricle 10 Years After Initial Resection
Sophia Zhou1, Michelle Bloom2, David R Wise3
1New York University Grossman School of Medicine, New York, New York, USA.
Background:
Renal cell carcinoma (RCC) accounts for 3% of solid malignancies, with clear cell RCC (ccRCC) comprising 80% of cases. Although 20%-30% of RCC cases are metastatic at diagnosis, cardiac metastases are rare.
Case Summary:
A 65-year-old man with a remote history of ccRCC developed progressive dyspnea. Evaluation showed pulmonary nodules and a fluorodeoxyglucose-avid left ventricular mass. Surgical resection confirmed ccRCC. He received dual immune checkpoint inhibitor therapy and achieved a complete response. His treatment was complicated by pneumonitis, which resolved with corticosteroids. He remains in remission off therapy.
Discussion:
This is a rare case of oligorecurrent RCC with cardiac metastasis without inferior vena cava involvement after prolonged remission. It emphasizes the complexity of decision-making because of extracardiac metastasis and treatment complications.
Take-Home Messages:
Cardiac metastasis is rare in oligorecurrent RCC, but relapse may occur even after prolonged latency periods. Appropriate treatment requires identification of other metastatic sites and a multidisciplinary approach.
