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Erschienen in:
09.09.2020 | Clinical Image
Cardiac Metastases from Renal Cell Carcinoma
Erschienen in: Journal of General Internal Medicine | Ausgabe 12/2020
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A 61-year-old man with clear cell renal cell carcinoma with multiorgan metastases treated with axitinib-pembrolizumab presented for follow-up. Restaging computed tomography (CT) with contrast showed disease progression to multiple organs, including new-onset cardiac metastases (Fig. 1). The patient reported no cardiac-related symptoms, although a transthoracic echocardiogram performed 1 month earlier had shown a pericardial effusion without cardiac metastases. Through shared decision-making, the patient opted to continue immunotherapy but died 1 month later secondary to complications of bowel perforation and brain metastases.
Figure 1
Contrast-enhanced computed tomography images. Panel a shows multiple myocardial left ventricular metastases (black arrowheads), a moderate-size pericardial effusion (white arrowheads), and the primary right renal cell carcinoma (black arrows). Axial images highlight the extent of the cardiac metastases (black arrowheads) below the level of the main bronchus (panel b) and close to the cardiac apex (panel c, arterial phase), as well as the pericardial effusion (white arrowheads).
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