Complete resolution of right atrium tumor thrombus with immunotherapy: A case report

Abstract

Renal cell carcinoma (RCC) is the most common malignancy of the kidney and has a propensity to metastasizing through the renal vein into the inferior vena cava thereby forming a tumor thrombus which can occasionally enlarge and extend into the right side of the heart. Treatment of RCC has been revolutionized with the introduction of immunotherapy as a standard first line treatment. However, the role of immunotherapy in RCC tumor thrombus extending to the heart is still not evidently understood as of now. Here, we describe a case of a 37-year-old male who presented with unintentional weight loss, shortness of breath, pedal edema and abdominal distension. He was diagnosed with metastatic RCC forming an inferior vena cava tumor thrombus extending to the right atrium and was treated with a combination of nivolumab and ipilimumab, for nine months following which there was a complete resolution of the right atrial tumor mass on imaging.

Keywords

• Nivolumab
• Ipilimumab
• Renal cell carcinoma
• Renal cell carcinoma tumor thrombus
• Right atrial tumor mass
• Immunotherapy