Left atrial extension of metastatic renal cell carcinoma via pulmonary vein: A case report

Abstract

Cardiac involvement from renal cell carcinoma is rare but well-recognized entity with several cases reported in literature. In majority of cases, the tumor reaches the right heart cavities through a neoplastic thrombus within inferior vena cava.  Other mechanisms are dissemination via hematogeous spread and direct extension from either mediastinal or lung lesions involving pulmonary veins. Left heart involvement from renal cell carcinoma with normal inferior vena cava is extremely rare. Direct extension of metastatic pulmonary mass to left atrium from renal cell carcinoma via pulmonary veins is even rarer.

We report a case of left atrial extension via pulmonary vein from metastatic renal cell carcinoma who presented with left cerebellar and right thalamic acute ischemic lesions along with multiple metastatic lesions.

Keywords

• Renal cell carcinoma,pulmonary vein,tumor embolus,left atrium

Metastatik renal hücreli karsinomun pulmoner ven yoluyla sol atriyuma uzanımı: Bir olgu sunumu

Öz

Renal hücreli karsinomun kardiyak tutulumu nadir ancak iyi bilinen bir olgudur ve literatürde bir çok vaka bildirilmiştir. Tümör çoğu durumda, sağ kalp boşluklarına vena kava inferiyor içinde neoplastik trombüs yoluyla ulaşır.  Bu mekanizma dışında, kardiyak tutulum, hematojen yolla olabileceği gibi, mediyastinal veya akciğer lezyonlarının pulmoner venler yoluyla direk yayılımı ile de ortaya çıkabilir. Ancak vena kava inferiyor tutulumu olmaksızın tümörün sol kalbe ulaşması son derece nadirdir.  Renal hücreli karsinomun akciğer metastazlarının, pulmoner venler yoluyla sol atriyuma direk uzanımı daha da nadirdir.

Bu makalede, çok sayıda metastatik lezyonu olan ve sol serebellar ve sağ talamik akut iskemik lezyonlara bağlı belirtileri ortaya çıkan,  pulmoner ven yoluyla sol atriyuma direk uzanımı olan metastatik renal hücreli karsinom olgusunu sunuyoruz.

Anahtar Kelimeler

• Renal hücreli karsinom,pulmoner ven,tümör embolisi,sol atrium

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