A case of surgical treatment for recurrence of right ventricular metastasis due to renal cell carcinoma after molecular targeted therapy

TL;DR

A 61-year-old man had successful surgery to remove a recurring heart tumor caused by kidney cancer after targeted therapy failed to eliminate it.

Contribution

This case demonstrates the effectiveness of surgical resection for recurrent right ventricular metastasis after molecular therapy.

Findings

Surgical resection effectively removed the recurrent right ventricular tumor.

Molecular targeted therapy controlled lung metastases but not the heart tumor.

The patient had no cardiac recurrence after 2 years of follow-up.

Abstract

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.

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