Korean Circ J.  2010 Aug;40(8):410-413. 10.4070/kcj.2010.40.8.410.

Left Ventricular Metastasis From Renal Cell Carcinoma Causing Left Ventricular Outflow Tract Obstruction

• Lee HJ
• Park JI
• Lim BH
• Seo JW
• Kang EM
• Lee BU
• Kim YJ

• KMID: 2145534
• DOI: http://doi.org/10.4070/kcj.2010.40.8.410

Abstract

Most cases of cardiac metastasis from renal cell carcinoma (RCC) involve the vena cava or right atrium. Left ventricular metastases from RCC without involving the vena cava or right atrium are extremely rare. Herein we report a case of RCC with left ventricular metastasis causing left ventricular outflow obstruction (LVOT).

Keyword

Renal cell carcinoma; Heart neoplasms; Metastasis; Heart ventricles; Echocardiography

MeSH Terms

Carcinoma, Renal Cell
Echocardiography
Heart Atria
Heart Neoplasms
Heart Ventricles
Neoplasm Metastasis
Ventricular Outflow Obstruction

Figure

• 

  Fig. 1 Renal cell carcinoma (RCC) with left ventricular and pulmonary metastases, but without right ventricular metastasis. A: abdominal computed tomography (CT) shows a very large RCC in the left kidney (white arrow) with thickening of the renal fascia. B: pathology obtained from the renal biopsy shows a typical clear cell renal cell carcinoma (H&E stain, ×200). C: plain chest radiograph shows cardiomegaly, right hilar enlargement, and reticular opacities in both lungs. D: chest CT shows a heterogenous mass lesion (white arrow) involving the entire left ventricle without right ventricular metastasis. E: multiple pulmonary nodules consistent with pulmonary metastases. Note underlying lung emphysema. F: a large metastatic lymph node in the right hilar area (white arrow).

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  Fig. 2 Two-dimensional (2D) echocardiography of metastasis to the left ventricle (LV) from renal cell carcinoma, with no metastasis in the inferior vena cava (IVC). (A) 2D echocardiogram shows a very large, lobulated, oscillating mass attached to the lateral wall of the LV and occupying the cavity of the LV (B), and (C) color flow Doppler showing turbulent jet and continuous-wave Doppler velocity through the left ventricular outflow tract (LVOT). (D) No evidence of mass in IVC (*).

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