Right heart failure caused by metastatic renal cell carcinoma masquerading as an obstructive cardiac tumour

We present a rare case of renal cell carcinoma (RCC) in a 58-year-old Hispanic woman presenting with progressive shortness of breath of 2 months duration. Physical examination was remarkable for jugular venous distension, pedal oedema and left flank fullness. An initial transthoracic echocardiogram revealed a large, greater than 4×3 cm solid mass extending from the inferior vena cava (IVC) into the right atrium (figure 1). Subsequently, a 64-slice contrast-enhanced axial helical CT scan of the chest, abdomen and pelvis revealed a very large lobulated heterogeneously enhancing mass …