Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2014; 2(8): 377-379
Published online Aug 16, 2014. doi: 10.12998/wjcc.v2.i8.377
Transthoracic echo: A sensitive tool for detecting cardiac extension of renal cell carcinoma?
Michelle Bejarano, Yara L Cameron, Theodore C Koutlas, Assad Movahed
Michelle Bejarano, Yara L Cameron, Theodore C Koutlas, Assad Movahed, Department of Cardiovascular Sciences, East Carolina Heart Institute and Brody School of Medicine, Greenville, NC 27834, United States
Author contributions: Bejarano M and Cameron YL designed the report; Movahed A and Bejarano M were attending physicians for the patient; Koutlas TC performed the surgical operation; Bejarano M and Movahed A performed the image diagnosis.
Correspondence to: Assad Movahed, MD, Department of Cardiovascular Sciences, East Carolina Heart Institute and Brody School of Medicine, 115 Heart Drive, Greenville, NC 27834, United States. movaheda@ecu.edu
Telephone: +1-252-7444400 Fax: +1-252-7447724
Received: March 31, 2014
Revised: May 22, 2014
Accepted: June 10, 2014
Published online: August 16, 2014
Abstract

Renal cell carcinoma is a common urological malignancy with the unique ability to invade the inferior vena cava (IVC) and to extend into the right atrium of the heart. Of those with Renal cell carcinoma only 4%-25% are found to have IVC invasion and of those only 2%-10% extend into the right atrium. If treated surgically, extension of tumor thrombus is not a determinant of survival; therefore it is imperative to determine the presence and extent of tumor thrombus in order to determine surgical approach and tumor resection. To date this has been primarily accomplished by magnetic resonance imaging and computed tomography. We present a case of 61 years old African American woman in which transthoracic echocardiography provided a more accurate determination/characterization of the presence and degree of tumor thrombus and extension.

Keywords: Renal cell carcinoma, Tumor thrombus, Cardiac extension, Right atrial mass

Core tip: Renal cell carcinoma is a common urological malignancy with the ability to invade the inferior vena cava and to extend into the right atrium of the heart. If treated surgically, extension of tumor thrombus is not a determinant of survival; therefore it is imperative to determine the presence and extent of tumor thrombus. To date, this has been primarily accomplished by magnetic resonance imaging and computed tomography; however, we present a case in which transthoracic echocardiography provided a more accurate determination/characterization of the presence and degree of tumor thrombus and extension.