Cardiac Metastasis of Medullary Phenotype Unclassified Renal Cell Carcinoma: A Case Report

Renal medullary carcinoma is an uncommon and aggressive variant of renal cell carcinoma (RCC), accounting for less than 0.5% of all RCC cases.It predominantly affects young individuals with sickle cell hemoglobinopathies.However, as seen in this case, unclassified medullary phenotypic RCC without hemoglobinopathy can also occur.This case report discusses a patient diagnosed with unclassified RCC of the medullary phenotype, exhibiting metastases to the left ventricle and liver.Diagnosis was confirmed through percutaneous biopsy, revealing loss of SMARCB1 expression along with positive vimentin and OCT3/4 staining.Treatment included chemotherapy with carboplatin and paclitaxel, followed by second-line therapy with cabozantinib.Left ventricular metastasis and cardiac lesions are rare but poor prognostic features of RCC.This case, one of the few documented in the literature, underscores the importance of a multidisciplinary approach to diagnosis and treatment.