Dataset Information

Rapidly Growing Right Ventricular Outflow Tract Mass in Patient with Sarcomatoid Renal Cell Carcinoma.

ABSTRACT: Cardiac metastasis from renal cell carcinoma (RCC) without inferior vena cava (IVC) involvements is extremely rare with few reported cases. Sarcomatoid RCC with rhabdoid feature is a rare pathologic type of RCC having aggressive behavior due to great metastatic potential. Here, we report a case of rapidly growing cardiac metastasis of RCC which brought on right ventricular outflow tract (RVOT) obstruction without IVC and right atrial involvement in a 61-year-old woman. Cardiac arrest occurred during radical nephrectomy and echocardiography revealed mass nearly obstructing the RVOT which was not recognized by preoperative echocardiography 1 month ago. Postoperative immunohistochemical evaluation of renal mass revealed sarcomatoid RCC with rhabdoid feature.

SUBMITTER: Hwang J

PROVIDER: S-EPMC5234337 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Rapidly Growing Right Ventricular Outflow Tract Mass in Patient with Sarcomatoid Renal Cell Carcinoma.

Hwang Jongmin J Park Yong Hyun YH Choi Kyung Un KU Kim Jeong Su JS Hwang Ki Won KW Lee Sang Hyun SH Chon Min Ku MK Lee Soo Yong SY Lee Dae Sung DS

Journal of cardiovascular ultrasound 20161228 4

Cardiac metastasis from renal cell carcinoma (RCC) without inferior vena cava (IVC) involvements is extremely rare with few reported cases. Sarcomatoid RCC with rhabdoid feature is a rare pathologic type of RCC having aggressive behavior due to great metastatic potential. Here, we report a case of rapidly growing cardiac metastasis of RCC which brought on right ventricular outflow tract (RVOT) obstruction without IVC and right atrial involvement in a 61-year-old woman. Cardiac arrest occurred du ...[more]

PMID: 28090262

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Project description:Background The ventricular premature complexes (PVCs) originating from the superior right ventricular outflow tract (RVOT) have high success rates by catheter ablation. It may not be the same when the origin is in the inferior RVOT. Objective To identify electrocardiographic (ECG) characteristics that predict the site for successful ablation of PVCs originating in the inferior RVOT. Methods Of 309 consecutive patients with symptomatic PVCs despite medical therapy, 124 had PVCs originating from the RVOT, and 107 RVOT cases without structural heart disease and no bundle branch block in sinus rhythm were enrolled in the study. Among them, 74 have a superior RVOT origin, and 33 have an inferior RVOT origin. Results The proportion with multiple morphologies of PVC was significantly higher in the inferior RVOT group than in the superior RVOT group (24.24 vs. 6.76%, P = 0.011). The QRS duration of PVCs with an inferior RVOT origin was more expansive than PVCs with a superior RVOT origin (162.42 ± 19.69 ms vs. 140.90 ± 11.30 ms; P < 0.001). Furthermore, the QRS wave in V1 in patients in the inferior RVOT group was more likely to have a negative delta wave at the onset of the QRS (27.27 vs. 1.39%, P < 0.001). We found that the areas under the receiver-operating characteristic curve (AUCs) for PVC diagnosis with an inferior RVOT origin ranged from 0.812 to 0.841 depending on ECG features, with the highest AUC for the QRS duration of PVCs and the amplitude of R waves in lead II. These ECG indices had good predictability for judging the origin of PVCs in the RVOT; the best threshold for the QRS duration of PVCs was 145 ms, and the best thresholds for the amplitude of R waves in leads II, III, and aVF were 1.35, 1.35, and 1.15 mV, respectively. Conclusion When evaluating a patient with PVCs, the source is likely to be the inferior RVOT if the ECG presentation conforms to the morphological characteristics of the RVOT, meanwhile, the QRS wave is relatively broad and polymorphic, and the main waves in limb leads (II, III, and aVF) are upward with low amplitude.

Dataset Information

Rapidly Growing Right Ventricular Outflow Tract Mass in Patient with Sarcomatoid Renal Cell Carcinoma.

Publications

Rapidly Growing Right Ventricular Outflow Tract Mass in Patient with Sarcomatoid Renal Cell Carcinoma.

Similar Datasets

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