Renal Cell Carcinoma Metastasizing to the Myocardium: A Comprehensive Literature Review of Diagnostic and Therapeutic Challenges

Renal cell carcinoma is a type of cancer that occurs in adults and typically metastasizes to the lungs, liver, bone, and brain. Cardiac involvement is far less common and often goes unrecognized, as its clinical manifestations can mimic those of more prevalent cardiopulmonary conditions, leading to substantial morbidity. This review examines the epidemiology, mechanisms of spread, patterns of presentation, diagnostic approaches, and treatment strategies for renal cell carcinoma involving the myocardium. Mechanisms include direct extension through the inferior vena cava to the right atrium, hematogenous dissemination, and, less frequently, lymphatic spread. Clinical findings range from incidental imaging abnormalities to presentations involving heart failure, arrhythmias, or cardiac tamponade. Diagnosis relies on multimodal imaging, with echocardiography and cardiac MRI providing complementary information. Management options include surgery in selected cases and systemic therapies, although available evidence is mainly derived from case reports and small series. Overall outcomes remain poor. Early recognition, coordinated multidisciplinary care, and further research are needed to guide management in this rare clinical setting.