Hwang Jongmin, Park Yong Hyun, Choi Kyung Un, Kim Jeong Su, Hwang Ki Won, Lee Sang Hyun, Chon Min Ku, Lee Soo Yong, Lee Dae Sung
Department of Internal Medicine, Cardiovascular Center, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea.
J Cardiovasc Ultrasound. 2016 Dec;24(4):329-333. doi: 10.4250/jcu.2016.24.4.329. Epub 2016 Dec 28.
Cardiac metastasis from renal cell carcinoma (RCC) without inferior vena cava (IVC) involvements is extremely rare with few reported cases. Sarcomatoid RCC with rhabdoid feature is a rare pathologic type of RCC having aggressive behavior due to great metastatic potential. Here, we report a case of rapidly growing cardiac metastasis of RCC which brought on right ventricular outflow tract (RVOT) obstruction without IVC and right atrial involvement in a 61-year-old woman. Cardiac arrest occurred during radical nephrectomy and echocardiography revealed mass nearly obstructing the RVOT which was not recognized by preoperative echocardiography 1 month ago. Postoperative immunohistochemical evaluation of renal mass revealed sarcomatoid RCC with rhabdoid feature.
肾细胞癌(RCC)发生心脏转移且未累及下腔静脉(IVC)极为罕见,报道的病例很少。具有横纹肌样特征的肉瘤样肾细胞癌是肾细胞癌的一种罕见病理类型,因其具有巨大的转移潜能而具有侵袭性。在此,我们报告一例61岁女性患者,肾细胞癌发生快速生长的心脏转移,导致右心室流出道(RVOT)梗阻,未累及下腔静脉和右心房。根治性肾切除术期间发生心脏骤停,超声心动图显示肿块几乎阻塞右心室流出道,而1个月前的术前超声心动图未发现该肿块。对肾肿块进行术后免疫组化评估,结果显示为具有横纹肌样特征的肉瘤样肾细胞癌。