Work

Renal cell carcinoma masquerading as acute exacerbation of right-sided heart failure: a case report

Year: 2026

Type: article

Abstract: BACKGROUND: Renal cell carcinoma is the most common malignancy involving the kidney. This cancer has a propensity for extensive invasion and metastatic spread. Tumor thrombus invasion into the inferior vena cava or renal vein occurs in less than 15% of patients with late stage renal cell carcinoma. Further extension up the inferior vena cava into the chambers of the heart is exceedingly rare, documented in less than 1% of all cases. CASE PRESENTATION: Here, we report a case of renal cell carcinoma presenting with what appeared to be an acute exacerbation of right-sided congestive heart failure and fluid overload in a 59-year-old African American male patient. Subsequent imaging revealed the presence of a primary renal cell carcinoma, diffuse metastatic lesions, and intravascular tumor thrombus extension from the inferior vena cava into the right atrium. CONCLUSION: This case highlights the diagnostic challenges of RCC due to its diverse metastatic potential and propensity for multisystem complications. Furthermore, it emphasizes the importance of considering a broad range of possibilities in the clinical context of suspected occult malignancy.

Source: Journal of Medical Case Reports

DOI: 10.1186/s13256-025-05759-1

Authors: Claire Victoria Ong, Kaitlyn V. Novotny, Michael V. Dicaro, Wolfram Samlowski, Aditi Singh

Institution: University of Nevada, Las Vegas

Language: English

Topic: Renal cell carcinoma treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,890