Pothiawala S, deSilva S, Norbu K. Ball-shaped right atrial mass in renal cell carcinoma: A case report. World J Crit Care Med 2022; 11(3): 192-197 [PMID: 35666699 DOI: 10.5492/wjccm.v11.i3.192]
Corresponding Author of This Article
Sohil Pothiawala, MBBS, MD, Doctor, Department of Emergency Medicine, Woodlands Health, Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore. drsohilpothiawala@yahoo.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. May 9, 2022; 11(3): 192-197 Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.192
Ball-shaped right atrial mass in renal cell carcinoma: A case report
Sohil Pothiawala, Savan deSilva, Kunzang Norbu
Sohil Pothiawala, Department of Emergency Medicine, Woodlands Health, Singapore 768024, Singapore
Savan deSilva, Kunzang Norbu, Department of Emergency Medicine, Sengkang General Hospital, Singapore 544886, Singapore
Author contributions: Pothiawala S lead conceptualization and wrote the original draft, reviewed and edited the draft; de Silva S and Norbu K wrote the original draft, reviewed and edited the draft.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sohil Pothiawala, MBBS, MD, Doctor, Department of Emergency Medicine, Woodlands Health, Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore. drsohilpothiawala@yahoo.com
Received: October 24, 2021 Peer-review started: October 24, 2021 First decision: December 2, 2021 Revised: December 8, 2021 Accepted: March 15, 2022 Article in press: March 15, 2022 Published online: May 9, 2022
Abstract
BACKGROUND
Renal cell carcinoma (RCC) is an aggressive tumor, with an incidental discovery in most patients. Classic presentation is rare, and it has a high frequency of local and distant metastasis at the time of detection.
CASE SUMMARY
We present a rare case of a 58-year-old man with a ball-shaped thrombus in the right atrium at the time of first incidental identification of RCC in the emergency department. Cardiac metastasis, especially thrombus in the right atrium, is rare. It could either be a bland thrombus or a tumor thrombus, and physicians should consider this potentially fatal complication of RCC early at the time of initial presentation.
CONCLUSION
Ball-shaped lesions in the right atrium are rare, and bland thrombus should be differentiated from tumor thrombus secondary to intracardiac metastasis.
Core Tip: The classic presentation of renal cell carcinoma is rare, and patients can present with atypical symptoms and local or distant metastasis at the time of initial detection. Cardiac metastasis, especially thrombus in the right atrium, is rare and emergency physicians should consider it early at the time of presentation. Detection of a ball-shaped lesion in the right atrium is rare, and the patient should undergo appropriate evaluation with the aim to differentiate bland thrombus from a tumor thrombus secondary to intracardiac metastasis, as it aids in therapeutic management and prognosis.
