Key result
Resection plus dual immunotherapy achieves complete response in rare late renal cell LV metastasis.
Why the study?
Cardiac metastases from renal cell carcinoma are rare and clinical management is complex due to extracardiac metastases and treatment complications.
Case Report (n=1)
This case demonstrates that rare cardiac metastases can occur even after prolonged remission in renal cell carcinoma, highlighting the role of surgical and immunotherapeutic multidisciplinary management.
Surgical resection plus dual ICI may control symptomatic cardiac ccRCC metastasis; hypothesis-generating and requires prospective validation before wider use.
BACKGROUND: Renal cell carcinoma (RCC) accounts for 3% of solid malignancies, with clear cell RCC (ccRCC) comprising 80% of cases. Although 20%-30% of RCC cases are metastatic at diagnosis, cardiac metastases are rare. CASE SUMMARY: A 65-year-old man with a remote history of ccRCC developed progressive dyspnea. Evaluation showed pulmonary nodules and a fluorodeoxyglucose-avid left ventricular mass. Surgical resection confirmed ccRCC. He received dual immune checkpoint inhibitor therapy and achieved a complete response. His treatment was complicated by pneumonitis, which resolved with corticosteroids. He remains in remission off therapy. DISCUSSION: This is a rare case of oligorecurrent RCC with cardiac metastasis without inferior vena cava involvement after prolonged remission. It emphasizes the complexity of decision-making because of extracardiac metastasis and treatment complications. TAKE-HOME MESSAGES: Cardiac metastasis is rare in oligorecurrent RCC, but relapse may occur even after prolonged latency periods. Appropriate treatment requires identification of other metastatic sites and a multidisciplinary approach.
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Zhou et al. (2026) conducted a case report in Clear cell renal cell carcinoma with left ventricular metastasis (n=1). Surgical resection and dual immune checkpoint inhibitor therapy was evaluated. Surgical resection and dual immune checkpoint inhibitor therapy achieved a complete response in 1 patient with left ventricular metastasis 10 years after initial renal cell carcinoma resection.
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