Satpathy Ruby, Lynch Joseph, Mohiuddin Syed M
Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska 68131, USA.
Echocardiography. 2008 May;25(5):521-5. doi: 10.1111/j.1540-8175.2008.00634.x. Epub 2008 Feb 13.
Right ventricular metastases from renal cell carcinoma without inferior vena cava (IVC) or right atrium involvement are rare. We discuss a 44-year-old male who presented with a left thigh mass, which was resected and the pathology revealed an epithelial sarcoma or a possible metastasis from another organ. His preradiotherapy cardiac evaluation showed mass in the right and left ventricles, which was confirmed by transesophagial echocardiogram. Computed tomography revealed a right renal mass in addition to the ventricular masses without any involvement of IVC or the atria. The patient underwent right radical nephrectomy without complications and systemic chemotherapy with interleukin-1 for metastatic renal cell carcinoma. He is doing well and follow-up echocardiogram showed significant reduction in the size of the cardiac metastases, even without surgical resection of these tumors. Thus, our article presents this unique case of asymptomatic ventricular metastases of renal cell carcinoma without any atrial or caval involvement and provides a new insight into the management of this syndrome.
肾细胞癌发生右心室转移且未累及下腔静脉(IVC)或右心房的情况较为罕见。我们讨论了一名44岁男性,他因左大腿肿块就诊,肿块切除后病理显示为上皮样肉瘤或可能来自其他器官的转移瘤。他放疗前的心脏评估显示左右心室均有肿块,经食管超声心动图得以证实。计算机断层扫描显示除心室肿块外还有右肾肿块,IVC或心房未受累。患者接受了根治性右肾切除术,未出现并发症,并接受了针对转移性肾细胞癌的白细胞介素-1全身化疗。他情况良好,随访超声心动图显示心脏转移瘤大小显著缩小,即便未对这些肿瘤进行手术切除。因此,我们的文章呈现了这例肾细胞癌无症状心室转移且未累及任何心房或腔静脉的独特病例,并为该综合征的治疗提供了新的见解。