Spontaneous rupture of renal cell carcinoma with sudden death due to myocardiac metastases: A case report

Cardiac metastasis in the absence of inferior vena cava (IVC) extension is extremely rare. We report a case of myocardiac metastasis from renal cell carcinoma (RCC) without IVC involvement. An 81-year-old female with left flank pain was referred to own clinic and CT revealed left huge renal mass with an extension to left renal vein, descending colon involvement, and multiple lymph node and lung metastases. The following day, she was brought to the emergency room in a state of shock with severe abdominal pain. CT showed spontaneous rupture of RCC. We performed transcatheter arterial embolization and left transabdominal nephrectomy with partial descending colectomy. After the operation CT and echocardiography revealed cardiac metastasis. Postoperative course was uneventful, however, she suddenly died 39 days after the operation. Autopsy revealed myocardiac metastases of RCC, and blockade of the conducting system of the heart was considered to have caused the severe arrhythmia and sudden cardiac arrest.