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Eur J Cardiothorac Surg 2008;33:110. doi:10.1016/j.ejcts.2007.09.022
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Diagnostic image investigation of a left atrial metastasis of sarcomatoid renal cell carcinoma

Justus T. Strauch*, Navid Madershahian, Thorsten Wahlers

Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Street 62, 50924 Cologne, Germany

Received 7 August 2007; received in revised form 17 September 2007; accepted 18 September 2007.

* Corresponding author. Tel.: +49 221 478 5531; fax: +49 221 478 4186. (Email: justus.strauch{at}uk-koeln.de).

Key Words: Cardiac tumor • Cardiac metastasis

An MRI study showed a structure based at the right lower pulmonary vein, posterior LA wall and MV posterior leaflet (Figs. 1a and 2 ). Tumor was dislodged from the MV leaflet and LA cavity (Fig. 1b).


Figure 1
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  		Fig. 1. (a) Pre-operative MR image evidencing an enhanced solid tumor originating from a broad base at the posterior left atrial wall partially occluding the lower right pulmonary vein with marked reduction in the LA cavity size. (b) Post-operative MR image showing the tumor free left atrium.

 

Figure 2
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  		Fig. 2. Intraoperative specimen. The tumor presents with numerous avascular papillary fronds covered by a single-layer endothelium.

 
Sarcomatoid metastases of LA are rare, especially from primary renal cell carcinoma. Radical resection and chemotherapy of the extremely malign tumor are required.





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