Right and left atrial metastasis of renal cell carcinoma: A case report

INTRODUCTION AND IMPORTANCE: Cardiac tumors are uncommon with an estimated incidence of 0.002–0.3 % in autopsy series. Most cardiac tumors are metastatic in nature. Renal cell carcinoma (RCC) metastatic to the heart without inferior vena cava (IVC) contiguous involvement is extremely rare with about 31 cases reported in the literature and only one case with bilateral atrial metastases. CASE PRESENTATION: In this report, the surgical management of metachronous RCC involving the right and left atrium is described in a 41-year-old male patient three years after initial diagnosis who presented with worsening episodes of cough, dyspnea, chest pain and hemoptysis. Transesophageal echocardiogram revealed significant inflow obstruction. The patient underwent bilateral atrial mass excision via median sternotomy. The postoperative period was unremarkable, and the patient was referred to medical oncology to pursue further treatment. CLINICAL DISCUSSION: Among the reported cases of cardiac RCC metastases without contiguous IVC involvement, bilateral atrial metastases are exceedingly rare. To our knowledge, this is the first case with bilateral atrial involvement to undergo surgical resection reported in the literature. CONCLUSION: Isolated biatrial cardiac metastases from RCC can be successfully resected with good outcomes in selected patients.