Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.192
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
Processing time: 195 Days and 4 Hours
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.
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.
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.