Renal cell carcinoma with intramyocardial metastases

BMC Urology

Case Report

Cezary Szczylik¹  Anna M Czarnecka²  Pawel Sobczuk³  Fei Lian⁴ 

[1] Department of Oncology, Military Institute of Medicine, Warsaw, Poland;Department of Oncology, Military Institute of Medicine, Warsaw, Poland;Department of Oncology, Military Institute of Medicine, Laboratory of Molecular Oncology, Szaserow 128, 04-141, Warsaw, Poland;Department of Oncology, Military Institute of Medicine, Warsaw, Poland;The Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland;Emory University School of Medicine, Atlanta, GA, USA;

关键词: Renal cell carcinoma;    Myocardium;    Metastasis;    Pazopanib;    Axitinib;   

DOI  :  10.1186/1471-2490-14-73

 received in 2014-03-22, accepted in 2014-08-05,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCardiac metastases from renal cell carcinoma without vena caval involvement are extremely rare with a limited number of cases reported in the worldwide literature until now. Nevertheless, this rare location of metastasis may significantly influence patient treatment and prognosis. Cooperation between oncology, cardiology, and urology teams are indispensable in cases of patients suffering from intramyocardial tumors. For these individuals, treatment guidelines based on large-scale studies are unavailable and only case/case series analysis may provide clinicians with decision assistance.Case presentationIn this paper, we report a case of a 50-year-old Caucasian male diagnosed with a 10.2 × 10.3 × 10.0 cm lower pole left renal mass in January 2002. He was subsequently treated with immunochemotherapy, tyrosine kinase inhibitors (TKIs), and mTOR inhibitors (mTORIs) - that is sunitinib, everolimus, and sorafenib. In March 2012, contrast-enhancing tumors in the left myocardium (∅22 mm) and in the interventricular septum (∅26 mm) were seen on CT. Cardiology testing was conducted and the patient was treated with pazopanib with a profound response. Overall survival since the clear cell renal cell carcinoma (ccRCC) diagnosis was 11 years 2 months and since diagnosis of multiple heart metastases was 1 year.ConclusionsCardiac metastases present a unique disease course in renal cell carcinoma. Cardiac metastases may remain asymptomatic, as in the case of this patient at the time of diagnosis. The most common cardiac presentation of renal cell carcinoma is hypertension, but other cardiac presentations include shortness of breath, cough, and arrhythmias. Targeted systemic therapy with tyrosine kinase inhibitors may be useful for this group of patients, but necrosis in the myocardium can result in tamponade and death. Regular cardiac magnetic resonance imaging scans are required for treatment monitoring.

【 授权许可】

CC BY   
© Czarnecka et al.; licensee BioMed Central Ltd. 2014