We report the case of a 41-year-old man with symptoms of exertional dyspnoea and easy fatigue.
Physical examination revealed a palpable mass with knocking pain over the right flank region and a cardiac murmur with jugular vein engorgement. Transoesophageal echocardiography revealed a right atrial mass that caused tricuspid inflow obstruction. Computed tomography revealed a giant mass (approximately 15 x 15 cm2 in the right kidney; this finding was consistent with renal cell carcinoma. Despite the metastatic status, right nephrectomy was performed and the intra-atrial tumour thrombus (TT) was resected under a cardiopulmonary bypass in order to relieve the tricuspid obstruction. Histological examination confirmed renal cell carcinoma with TT. The patient is healthy with satisfactory systolic function at 1-year follow-up.
Written by:
Lin CT, Tsai CS, Hong GJ, Tsai YT, Lee CY. Are you the author?
Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defence Medical Centre, Taipei, Taiwan.
Reference: Acta Chir Belg. 2011 Nov-Dec;111(6):404-6.
PubMed Abstract
PMID: 22299331
UroToday.com Renal Cancer Section