Renal Cell Carcinoma With Cardiac Metastases

Steven Li Fraine, Diana Coman, Madeleine Durand, Mikhael Laskine


The median survival of metastatic renal cell carcinoma (mRCC) is 5 months with a 1-year survival rate of 29%. Cardiac metastasis from RCC is a rare finding and there is scarce data available on treatment options. Recently, the combination of nivolumab and ipilimumab has been approved as a first-line treatment for advanced RCC in patients with a poor prognosis. Here we present a case of a 45-year-old male who presented to the emergency room with cough, dyspnea, and fever. Chest X-ray showed hilar lymphadenopathy and diffuse reticulonodular opacities, whereas a thoracic computed tomography (CT) scan revealed carcinomatosis lymphangitis, pleural carcinosis and multiple heterogenous zones on the cardiac wall. A transthoracic echocardiogram and a cardiac magnetic resonance imaging (MRI) revealed cardiac metastases. Subsequent imaging showed abundant distal metastases whereas a renal biopsy confirmed clear cell RCC making it a high-grade stage IV metastatic RCC. The patient was treated with the combination of nivolumab and ipilimumab. The unique feature about this case is that we have found a rare case of cardiac metastases that persists after a 3-month follow-up. Previously, there was only one case report of a patient with RCC and cardiac metastases who showed persistent response to nivolumab after 12 months. The key points from this case report are that a high index of suspicion is required for diagnosing cardiac metastases given that the signs and symptoms of metastatic cardiac involvement can be non-specific. Spread has been described as directly through the renal vein and vena cava or indirectly via the lymphatic system, which confers a worse prognosis. Furthermore, cardiac metastases can be mistaken for thrombi, endocarditis, or primary tumors, therefore echocardiograms can be limiting. Supplemental imaging with cardiac MRI or positron emission tomography/CT (PET/CT) is often needed for further characterization.

World J Oncol. 2021;12(4):124-126


Renal cell carcinoma; Cardiac metastases; Immunotherapy; Tyrosine kinase inhibitors

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



World Journal of Oncology, bimonthly, ISSN 1920-4531 (print), 1920-454X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.