Images in Clinical Medicine
Echocardiographic Detection of a Renal-Cell Carcinoma
N Engl J Med 1998; 338:1279April 30, 1998
- Article
Figure 1 A 59-year-old man with hypertension presented with a three-month history of fatigue and progressive shortness of breath. Physical examination revealed mild jaundice, tachypnea, tachycardia, bibasilar rales, and mild hepatomegaly. Laboratory studies disclosed microcytic anemia and elevated concentrations of total bilirubin and alkaline phosphatase. Urinalysis revealed no evidence of hematuria or proteinuria. Transthoracic echocardiography performed to investigate heart failure demonstrated mild, concentric left ventricular hypertrophy and mild, diffuse left ventricular dysfunction. A standard subcostal view revealed a multilobar cystic mass (arrows in Panel A) in the inferior vena cava (IVC) that appeared to originate from the right kidney. At surgery, a renal-cell carcinoma, predominantly clear-cell type, was removed (arrows in Panel B; hematoxylin and eosin, ×40). The tumor (T) was in the right renal capsule (Panel C), with extension into the renal vein and inferior vena cava (arrow). The patient recovered uneventfully and was sent home on the 10th postoperative day. Fifteen months after surgery, he continues to do well.
Lori Bray Croft, M.D.
Martin E. Goldman, M.D.
Mount Sinai Medical Center, New York, NY 10029- Citing Articles (1)
Citing Articles
1
Stephan Eddicks, Dietmar Kivelitz, Christoph Breitwieser, Fabian Knebel, Heinz Theres, Gert Baumann, Adrian Constantin Borges. (2006) Right Ventricular Metastasis Caused by a Renal Cell Carcinoma (Grawitz Tumor): Case Report. Journal of the American Society of Echocardiography 19:8, 1073.e11-1073.e15
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