- Email: [email protected]
A RARE CASE OF ISOLATED RENAL CELL CARCINOMA METASTASIS TO THE LEFT VENTRICLE
2146 JACC March 21, 2017 Volume 69, Issue 11
FIT Clinical Decision Making A RARE CASE OF ISOLATED RENAL CELL CARCINOMA METASTASIS TO THE LEFT VENTRICLE Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision‐Making: Non-Invasive Imaging and Valvular Heart Disease Abstract Category: Non Invasive Imaging Presentation Number: 1129-369 Authors: Hasmik Minasyan, Mitul Kanzaria, Thomas Jefferson University Hospital, Philadelphia, PA, USA Background: Cardiac metastasis from renal cell carcinoma (RCC) is rare in the absence of direct inferior vena cava extension. We describe a case of an isolated biopsy proven RCC metastasis to the left ventricular (LV) apex. Case: A 73-year-old asymptomatic man with a remote history of clear cell RCC had an abnormal screening electrocardiogram. A regadenoson nuclear stress test showed inferior ischemia; left heart catheterization subsequently revealed a well-circumscribed LV apical mass with large tumor blush (Fig 1A). Transthoracic echocardiogram with contrast demonstrated a 3.8 x 3.0 cm enhancing mass in the LV apex (Fig 1B). Cardiac MRI confirmed a mobile mass with hypervascular tissue characteristics infiltrating the apical inferior and inferolateral walls of the LV myocardium (Fig 1C, 1D, and 1E). Staging studies revealed no other metastases. Decision‐Making: After consultation with cardiothoracic surgery, radiology and oncology, the differential diagnosis included metastatic RCC versus a primary cardiac tumor. The safest biopsy method was deemed to be a mini left thoracotomy. The patient tolerated the procedure well and the biopsy confirmed metastatic RCC. He was discharged to home with outpatient oncology follow up for further treatment. Conclusions: Isolated RCC metastasis to the LV is a rare occurrence. This case report highlights the value of multimodality imaging for the assessment of metastases to the LV and a multidisciplinary approach to diagnosis and treatment of metastatic RCC to the LV.
FIT Clinical Decision Making A RARE CASE OF ISOLATED RENAL CELL CARCINOMA METASTASIS TO THE LEFT VENTRICLE Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision‐Making: Non-Invasive Imaging and Valvular Heart Disease Abstract Category: Non Invasive Imaging Presentation Number: 1129-369 Authors: Hasmik Minasyan, Mitul Kanzaria, Thomas Jefferson University Hospital, Philadelphia, PA, USA Background: Cardiac metastasis from renal cell carcinoma (RCC) is rare in the absence of direct inferior vena cava extension. We describe a case of an isolated biopsy proven RCC metastasis to the left ventricular (LV) apex. Case: A 73-year-old asymptomatic man with a remote history of clear cell RCC had an abnormal screening electrocardiogram. A regadenoson nuclear stress test showed inferior ischemia; left heart catheterization subsequently revealed a well-circumscribed LV apical mass with large tumor blush (Fig 1A). Transthoracic echocardiogram with contrast demonstrated a 3.8 x 3.0 cm enhancing mass in the LV apex (Fig 1B). Cardiac MRI confirmed a mobile mass with hypervascular tissue characteristics infiltrating the apical inferior and inferolateral walls of the LV myocardium (Fig 1C, 1D, and 1E). Staging studies revealed no other metastases. Decision‐Making: After consultation with cardiothoracic surgery, radiology and oncology, the differential diagnosis included metastatic RCC versus a primary cardiac tumor. The safest biopsy method was deemed to be a mini left thoracotomy. The patient tolerated the procedure well and the biopsy confirmed metastatic RCC. He was discharged to home with outpatient oncology follow up for further treatment. Conclusions: Isolated RCC metastasis to the LV is a rare occurrence. This case report highlights the value of multimodality imaging for the assessment of metastases to the LV and a multidisciplinary approach to diagnosis and treatment of metastatic RCC to the LV.