Late isolated metastasis of renal cell carcinoma in the left ventricular myocardium

Metastatic renal cell carcinoma (RCC) involving the heart is a rare phenomenon. We present a case of late metastasis of RCC in the left ventricular myocardium, 23 years after the patient had a nephrectomy for 'organ-confined' primary disease. Open surgical biopsy was required to confirm the diagnosis in this patient. Surgical management or resection of such a metastasis depends on the location and relationship of the tumor to the important local structures. Targeted systemic therapy may be useful for patients in whom complete resection of tumor is not possible.