Right atrial metastasis after renal cell carcinoma operation: a case report

Background: Treatment options for patients with high-risk metastatic clear cell renal cell carcinoma (mccRCC) include immune checkpoint inhibitors and tyrosine kinase inhibitors (TKIs), but clinical manifestations and treatment of these patients are rarely reported because patients with cardiac metastases and abrupt circulatory disorders are very rare and there are no precise guidelines to follow. In this study, we analyzed and discussed the clinical characteristics, related characteristics, pathogenesis and treatment strategies of patients with cardiac metastases of kidney cancer, so as to provide reference for the diagnosis and treatment of cardiac metastatic tumors. Case Description: The patient was diagnosed with renal cell carcinoma and underwent surgical radical resection, no special treatment was performed after surgery. Metastases of the right thigh muscles and both lungs were found after 4 years, and the patient was treated with 1 cycle of sunitinib + sintilimab. The patient had sudden symptoms of circulatory obstruction, computed tomography angiography (CTA) showed that the right atrial mass was occupied, and cardiac surgery was performed, and the postoperative pathology confirmed that it was kidney cancer heart metastasis, the operation was successful. The patient had aggravated lung infection after 2 weeks of follow-up, and the symptoms improved after treatment with antibiotics, anticoagulation, and nutritional support. This operation relieved the patient's circulatory embolism, saved the patient's life, and prolonged the patient's survival. Conclusions: This case study highlights the rare clinical manifestations of cardiac metastasis from ccRCC. For patients who have the opportunity for surgery, surgical treatment is recommended as the preferred option. Early detection and treatment are the key to prolonging the survival of patients with cardiac metastasis from tumors.