背景:包括右心室的肾细胞癌在内的心脏转移很少见。尚未建立针对肾细胞癌的心脏转移和复发的标准治疗方法。
方法:我们介绍了一个61岁的男性患者,该患者在分子靶向治疗后接受了肾细胞癌引起的复发性右心室转移切除术。首次进行心脏手术是由于肾细胞癌引起的右心室转移。患者术后病程良好。第一次手术两年后,然而,随访计算机断层扫描显示右心室肿瘤复发和双肺转移。分子靶向治疗有效控制了肺转移,但右心室病灶未改变,导致再次手术。通过体外循环辅助的胸骨正中切开术完全切除了复发性右心室肿瘤。患者术后病程顺利,于术后第13天出院。2年随访显示无心脏复发。
结论:手术干预被认为对分子靶向治疗后肾细胞癌右心室转移复发有帮助。
BACKGROUND: Cardiac metastasis including the right ventricle from renal cell carcinoma is rare. No standard treatment for cardiac metastasis and recurrence in renal cell carcinoma has been established.
METHODS: We present the case of a 61-year-old man who underwent the resection of recurrent right ventricular metastasis caused by renal cell carcinoma following molecular targeted therapy. The first cardiac operation was performed for right ventricular metastasis due to renal cell carcinoma. The patient had a good postoperative course. Two years after the first operation, however, follow-up computed tomography revealed the recurrence of the right ventricular tumor and metastases in both lungs. Molecular targeted therapy was carried out and effectively controlled the lung metastasis but the right ventricular lesion remained unchanged, leading to reoperation. The recurrent right ventricular tumor was completely resected through a redo median sternotomy assisted by cardiopulmonary bypass. The patient had an uneventful postoperative course and was discharged on the 13th postoperative day. Follow-ups at 2 years showed no cardiac recurrence.
CONCLUSIONS: Surgical intervention was considered useful in managing the recurrence of right ventricular metastasis from renal cell carcinoma after molecular targeted therapy.