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Sasaki K, Nishioka N, Yamamoto M, Kato K, Matsumoto R, Masuda T, Maruyama R, Kurimoto Y, Yamada A, Naraoka S. A case of surgical treatment for recurrence of right ventricular metastasis due to renal cell carcinoma after molecular targeted therapy. Surg Case Rep 2024; 10:137. [PMID: 38833185 DOI: 10.1186/s40792-024-01940-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND 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. CASE PRESENTATION 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. CONCLUSION 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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Affiliation(s)
- Keita Sasaki
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan.
| | - Naritomo Nishioka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Mika Yamamoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Kenichi Kato
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Ryo Matsumoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
| | - Shuichi Naraoka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-Ku, Sapporo, 006-8555, Japan
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Buttar C, Lakhdar S, Nassar M, Landry I, Munira M. Cabozantinib-Induced Severe Cardiac Dysfunction: A Case Report and a Systematic Review of the Literature. Cureus 2022; 14:e23740. [PMID: 35509750 PMCID: PMC9057634 DOI: 10.7759/cureus.23740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Cabozantinib is a novel multitargeted receptor tyrosine kinase inhibitor commonly used to treat advanced renal cell carcinoma. Cardiotoxicity is not a previously well-described adverse effect of cabozantinib. We present a rare case of a 74-year-old male with a history of renal cell carcinoma who underwent partial nephrectomy. The patient had been recently started on cabozantinib for advanced metastatic renal cell carcinoma. He developed acute onset of heart failure and subclinical hypothyroidism within nine months of treatment. Our case report postulates a causal relationship between cabozantinib and the development of non-ischemic cardiomyopathy.
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Cao J, Yang Y. 18F-FDG PET/CT detected recurrent renal cell carcinoma presenting with cardiac metastasis. J Nucl Cardiol 2021; 28:3085-3087. [PMID: 33977368 DOI: 10.1007/s12350-021-02652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jiahua Cao
- Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yuhua Yang
- Department of PET/CT, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
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Li Fraine S, Coman D, Durand M, Laskine M. Renal Cell Carcinoma With Cardiac Metastases. World J Oncol 2021; 12:124-126. [PMID: 34349857 PMCID: PMC8297046 DOI: 10.14740/wjon1376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/12/2021] [Indexed: 12/02/2022] Open
Abstract
The median survival of metastatic renal cell carcinoma (mRCC) is 5 months with a 1-year survival rate of 29%. Cardiac metastasis from RCC is a rare finding and there is scarce data available on treatment options. Recently, the combination of nivolumab and ipilimumab has been approved as a first-line treatment for advanced RCC in patients with a poor prognosis. Here we present a case of a 45-year-old male who presented to the emergency room with cough, dyspnea, and fever. Chest X-ray showed hilar lymphadenopathy and diffuse reticulonodular opacities, whereas a thoracic computed tomography (CT) scan revealed carcinomatosis lymphangitis, pleural carcinosis and multiple heterogenous zones on the cardiac wall. A transthoracic echocardiogram and a cardiac magnetic resonance imaging (MRI) revealed cardiac metastases. Subsequent imaging showed abundant distal metastases whereas a renal biopsy confirmed clear cell RCC making it a high-grade stage IV metastatic RCC. The patient was treated with the combination of nivolumab and ipilimumab. The unique feature about this case is that we have found a rare case of cardiac metastases that persists after a 3-month follow-up. Previously, there was only one case report of a patient with RCC and cardiac metastases who showed persistent response to nivolumab after 12 months. The key points from this case report are that a high index of suspicion is required for diagnosing cardiac metastases given that the signs and symptoms of metastatic cardiac involvement can be non-specific. Spread has been described as directly through the renal vein and vena cava or indirectly via the lymphatic system, which confers a worse prognosis. Furthermore, cardiac metastases can be mistaken for thrombi, endocarditis, or primary tumors, therefore echocardiograms can be limiting. Supplemental imaging with cardiac MRI or positron emission tomography/CT (PET/CT) is often needed for further characterization.
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Affiliation(s)
- Steven Li Fraine
- Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Diana Coman
- Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Madeleine Durand
- Division of General Internal Medicine, Department of Medicine, University of Montreal, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
| | - Mikhael Laskine
- Division of General Internal Medicine, Department of Medicine, University of Montreal, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
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Barajas-Ochoa A, Suero-Abreu GA. Cardiac Metastases from Renal Cell Carcinoma. J Gen Intern Med 2020; 35:3711-3712. [PMID: 32909231 PMCID: PMC7728881 DOI: 10.1007/s11606-020-06200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Aldo Barajas-Ochoa
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
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