# Right Atrial Mass and Severe Symptomatic Anemia as the Initial Presentation of Renal Cell Carcinoma

## TL;DR

A 63-year-old man with severe anemia and a heart mass was found to have advanced kidney cancer that had spread to his liver and heart.

## Contribution

This case report highlights the rare initial presentation of renal cell carcinoma involving the right atrium and severe anemia.

## Key findings

- A right atrial mass was identified as part of metastatic renal cell carcinoma.
- Severe symptomatic anemia was an initial symptom of advanced kidney cancer.
- Curative surgery was not pursued due to extensive disease and patient preference.

## Abstract

We present a case of a 63-year-old male with a history significant for hypertension and a 45-pack-year smoking history who presented with severe symptomatic anemia. Rather quickly, upon imaging, he was found to have a 10 cm liver mass, a right renal mass, and a right atrial mass. A liver biopsy was performed and confirmed metastatic renal cell carcinoma (clear cell variant). Due to the extensive disease burden and patient preference, curative surgery was not pursued. This case highlights the rare but critical complications that can present as the initial presentation of renal cell carcinoma.