Renal cell carcinoma with intramyocardial metastases

被引:15
作者
Czarnecka, Anna M. [1 ,5 ]
Sobczuk, Pawel [1 ,2 ,3 ]
Lian, Fei [4 ]
Szczylik, Cezary [1 ]
机构
[1] Mil Inst Med, Dept Oncol, Warsaw, Poland
[2] Med Univ Warsaw, Fac Med 2, English Div, Warsaw, Poland
[3] Med Univ Warsaw, Physiotherapy Div, Warsaw, Poland
[4] Emory Univ, Sch Med, Atlanta, GA USA
[5] Mil Inst Med, Dept Oncol, Mol Oncol Lab, PL-04141 Warsaw, Poland
来源
BMC UROLOGY | 2014年 / 14卷
关键词
Renal cell carcinoma; Myocardium; Metastasis; Pazopanib; Axitinib; TYROSINE KINASE INHIBITORS; RIGHT ATRIAL METASTASIS; CARDIAC METASTASIS; VENA-CAVA; SUNITINIB RECHALLENGE; TUMOR THROMBUS; INVOLVEMENT; RESISTANCE; SORAFENIB; VENTRICLE;
D O I
10.1186/1471-2490-14-73
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Cardiac metastases from renal cell carcinoma without vena caval involvement are extremely rare with a limited number of cases reported in the worldwide literature until now. Nevertheless, this rare location of metastasis may significantly influence patient treatment and prognosis. Cooperation between oncology, cardiology, and urology teams are indispensable in cases of patients suffering from intramyocardial tumors. For these individuals, treatment guidelines based on large-scale studies are unavailable and only case/case series analysis may provide clinicians with decision assistance. Case presentation: In this paper, we report a case of a 50-year-old Caucasian male diagnosed with a 10.2 x 10.3 x 10.0 cm lower pole left renal mass in January 2002. He was subsequently treated with immunochemotherapy, tyrosine kinase inhibitors (TKIs), and mTOR inhibitors (mTORIs) -that is sunitinib, everolimus, and sorafenib. In March 2012, contrast-enhancing tumors in the left myocardium (empty set22 mm) and in the interventricular septum (empty set26 mm) were seen on CT. Cardiology testing was conducted and the patient was treated with pazopanib with a profound response. Overall survival since the clear cell renal cell carcinoma (ccRCC) diagnosis was 11 years 2 months and since diagnosis of multiple heart metastases was 1 year. Conclusions: Cardiac metastases present a unique disease course in renal cell carcinoma. Cardiac metastases may remain asymptomatic, as in the case of this patient at the time of diagnosis. The most common cardiac presentation of renal cell carcinoma is hypertension, but other cardiac presentations include shortness of breath, cough, and arrhythmias. Targeted systemic therapy with tyrosine kinase inhibitors may be useful for this group of patients, but necrosis in the myocardium can result in tamponade and death. Regular cardiac magnetic resonance imaging scans are required for treatment monitoring.
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页数:8
相关论文
共 43 条
[1]  
Aburto J, 2009, TEX HEART I J, V36, P48
[2]   Cardiac metastasis from a renal cell carcinoma [J].
Alghamdi, Abdulaziz ;
Tam, James .
CANADIAN JOURNAL OF CARDIOLOGY, 2006, 22 (14) :1231-1232
[3]  
Bielecka ZF, 2013, CURR SIGNAL TRANSD T, V8, P219
[4]  
BRADLEY SM, 1995, ANN THORAC SURG, V60, P204
[5]   SPECT/CT [J].
Buck, Andreas K. ;
Nekolla, Stephan ;
Ziegler, Sibylle ;
Beer, Ambros ;
Krause, Bernd J. ;
Herrmann, Ken ;
Scheidhauer, Klemens ;
Wester, Hans-Juergen ;
Rummeny, Ernst J. ;
Schwaiger, Markus ;
Drzezga, Alexander .
JOURNAL OF NUCLEAR MEDICINE, 2008, 49 (08) :1305-1319
[6]   Resistance to tyrosine kinase inhibitors in clear cell renal cell carcinoma: From the patient's bed to molecular mechanisms [J].
Buczek, Magdalena ;
Escudier, Bernard ;
Bartnik, Ewa ;
Szczylik, Cezary ;
Czarnecka, Anna .
BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER, 2014, 1845 (01) :31-41
[7]  
Butz T, 2008, EUR J ECHOCARDIOGR, V9, P403, DOI [10.1093/ejechocard/jen026, 10.1016/j.euje.2007.02.006, 10.1093/ejechocard/jem074, 10.1093/ejechocard/jen018, 10.1093/ejechocard/jen153]
[8]   METASTATIC RENAL-CELL CARCINOMA TO THE RIGHT CARDIAC VENTRICLE WITHOUT CONTIGUOUS VENA-CAVAL INVOLVEMENT [J].
CARROLL, JC ;
QUINN, CC ;
WEITZEL, J ;
SANT, GR .
JOURNAL OF UROLOGY, 1994, 151 (01) :133-134
[9]  
Cheng ASH, 2003, INT J CLIN PRACT, V57, P437
[10]   Long-term survival after radical surgery for renal cell carcinoma with tumour thrombus extension into the right atrium [J].
Dominik, Jan ;
Moravek, Petr ;
Zacek, Pavel ;
Vojacek, Jan ;
Brtko, Miroslav ;
Podhola, Miroslav ;
Pacovsky, Jaroslav ;
Harrer, Jan .
BJU INTERNATIONAL, 2013, 111 (3B) :E59-E64