The Multidisciplinary Role of Echocardiography: From the Thrombus in Inferior Vena Cava to the Diagnosis of Renal Cell Carcinoma.

Clear renal cell carcinoma (RCC) represents the most prevalent type of kidney cancer, with a tendency for venous migration and extension into the inferior vena cava (IVC) in 4%-10% of the cases. Herein, we present a case report of a patient with acute coronary syndrome and an incidental echocardiographic finding of a thrombus in the IVC, which contributed to the diagnosis of the RCC. A 67-year-old male patient was transferred to our clinic with high troponin levels and electrocardiogram changes suggestive of myocardial ischemia. Coronary angiography revealed occlusion of the right coronary artery and left anterior descending with normal flow through the graft. During the two-dimensional transthoracic echocardiographic examination, in the subcostal view, a thrombotic formation in the IVC was observed. A computed tomography of the abdomen showed an oval mass on the upper pole of the left kidney. The patient underwent an open radical nephrectomy. Pathological examination confirmed the diagnosis of clear RCC. The patient consulted the oncology department, where no specific oncological therapy was indicated. After a 2-year follow-up, ultrasound of the abdomen was normal, without relapse or metastatic dissemination of the RCC. Detailed echocardiographic assessment can reveal pathological changes even in the surrounding structures, which helps in the timely diagnosis and initiation of treatment in the early stages of the disease.