Clinical Image - Volume 3 - Issue 1

Renal carcinoma extended to the inferior vena cava and right atrium

H Bendahou*; T Ettachfini; M Rochd; M Haboub; R Habbal

Department of Cardiology, University Hospital of IbnRochd, Casablanca, Morocco.

Received Date : Nov 14, 2022
Accepted Date : Dec 21, 2022
Published Date: Jan 11, 2023
Copyright:© H Bendahou 2023

*Corresponding Author : H Bendahou, Department of Cardiology, University Hospital of Ibn Rochd, Casablanca, Morocco.

Clinical Image

A 70-year-old man consulted for abdominal distention and cachexia with hematuria. An abdomino-pelvic CT scan performed showing a heterogeneous and vascularized tissue mass of the right kidney protruding into the right renal vein, the inferior vena cava and the right atrium with no sign of hemodynamic obstruction and an echocardiography showing an Intra-OD tumor-thrombus measuring 45*29mm, related to the extension of the renal tumour. Due to the advanced stage of the neoplasm and the severely altered clinical condition, the patient was placed in palliative care

Figure 1 : A- 4C viewdepicting the mass in the RA.

B- RV modified PLAX depicting the mass.

C- CT Scan Coronal viewdepicting the extention of the mass into the RA.


Cardiac metastases are twenty times more frequent than primary cardiac tumors. Cardiac involvement in renal carcinoma is often due to direct extension of tumor thrombus from the renal vein to the inferior vena cava and then to the right heart cavities [1]. Tumor extension to the venous system (renal vein, IVC) and the right cavities occurs in approximately 4 to 10% of cases in locally advanced renal carcinomas [2]. Several factors can influence the prognosis of patients with renal tumors. However, the importance of venous and cardiac extension still remains controversial. Renal carcinomas with stage T3 venous tumor thrombus are associated with a poor prognosis [3].


  1. Zairi Ihsen, Mzoughi Khadija, Jnifene Zouhayer, Fennira Sana, Ben Moussa Fethia, et al. Cardiacmetastasisfrom a renalcellcarcinoma. Pan AfricanMedical Journal. 2015; 22: 167. [DOI:10.11604/pamj.2015.22.167.7130].
  2. V Ficarra, R Righetti, A D'amico, et al. “Renalvein and vena cava involvementdoes not affect prognosis in patients withrenalcellcarcinoma,” Oncology. 2001; 61(1): 10-15.1.
  3. HL Kim, A Zisman, KR Han, RA Figlin, AS Belldegrun. “Prognosticsignificance of venous thrombus in renalcellcarcinoma. Are renalvein and inferior vena cava involvementdifferent?” Journal of Urology. 2004; 171(2): 588–591.