Sasaki Keita, Nishioka Naritomo, Yamamoto Mika, Kato Kenichi, Matsumoto Ryo, Masuda Takahiko, Maruyama Ryushi, Kurimoto Yoshihiko, Yamada Akira, Naraoka Shuichi
Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan.
Surg Case Rep. 2024 Jun 4;10(1):137. doi: 10.1186/s40792-024-01940-8.
Cardiac metastasis including the right ventricle from renal cell carcinoma is rare. No standard treatment for cardiac metastasis and recurrence in renal cell carcinoma has been established.
We present the case of a 61-year-old man who underwent the resection of recurrent right ventricular metastasis caused by renal cell carcinoma following molecular targeted therapy. The first cardiac operation was performed for right ventricular metastasis due to renal cell carcinoma. The patient had a good postoperative course. Two years after the first operation, however, follow-up computed tomography revealed the recurrence of the right ventricular tumor and metastases in both lungs. Molecular targeted therapy was carried out and effectively controlled the lung metastasis but the right ventricular lesion remained unchanged, leading to reoperation. The recurrent right ventricular tumor was completely resected through a redo median sternotomy assisted by cardiopulmonary bypass. The patient had an uneventful postoperative course and was discharged on the 13th postoperative day. Follow-ups at 2 years showed no cardiac recurrence.
Surgical intervention was considered useful in managing the recurrence of right ventricular metastasis from renal cell carcinoma after molecular targeted therapy.
包括右心室转移在内的心脏转移瘤在肾细胞癌中较为罕见。目前尚未确立针对肾细胞癌心脏转移及复发的标准治疗方法。
我们报告一例61岁男性患者，其在接受分子靶向治疗后，因肾细胞癌导致右心室转移复发而接受了手术切除。首次心脏手术是针对肾细胞癌引起的右心室转移进行的。患者术后恢复良好。然而，首次手术后两年，随访计算机断层扫描显示右心室肿瘤复发且双肺出现转移。进行了分子靶向治疗，有效控制了肺转移，但右心室病变无变化，因此进行了再次手术。通过在体外循环辅助下再次正中开胸，将复发的右心室肿瘤完全切除。患者术后恢复顺利，术后第13天出院。两年随访显示无心脏复发。
手术干预被认为对分子靶向治疗后肾细胞癌右心室转移复发的治疗有效。
