Late Renal Cell Carcinoma Metastasis to the Right Ventricle without Caval Involvement

(Department of Cardiovascular Surgery, Saitama Municipal Hospital, Saitama, Japan)

Satoru Suzuki Kenichi Hashizume Yoshiyuki Haga
A 72-year-old woman was admitted to our hospital because of a mass in the right ventricle. She has a history of renal cell carcinoma of the left kidney, which was completely removed by nephrectomy in 1996. Echocardiography, CT and MRI showed a large tumor in the right ventricle without any inferior vena cava involvement. A biopsy performed on that tumor confirmed that the tumor was a metastatic tumor in the right ventricle from the renal cell carcinoma. The tumor grew quickly, and almost completely obstructed the right ventricular outflow tract. On February 24, 2004; an operation was performed to remove the tumor, which protruded from the ventricular septum and occupied the right ventricular cavity from the attachment of the tricuspid valve to the right ventricular outflow tract close to the pulmonary valve. A transannular patch was placed in order to dilate the right ventricular outflow tract. Histopathology diagnosed that the tumor was a metastasis from the renal cell carcinoma. The postoperative course was uneventful. Interleukin-2 was administered postoperatively. Echocardiography performed eight months after the surgery showed that although the tumor in the right ventricle had grown, it had not produced stenosis of the right ventricular outflow tract. The patient died as a result of the recurrent tumor blocking the right ventricular outflow tract 11.5 months after the surgery.
@Jpn. J. Cardiovasc. Surg. 34: 440-444i2005j