Sunitinib malate, a receptor tyrosine kinase inhibitor, is effective in the treatment of restrictive heart failure due to heart metastases from renal cell carcinoma.

Few systematic trials have studied metastatic tumors to the heart and there are currently no guidelines for the treatment of heart metastases and its associated symptoms. This article presents the first known case of effective pharmacological treatment of heart failure due to metastases of renal cell carcinoma (RCC). Due to pressure caused by metastatic tissue on the left atrium and the decreased blood inflow to the left ventricle, the 61-year-old male patient suffered from dyspnea. Treatment with sunitinib, an oral multitargeted receptor tyrosine kinase inhibitor, was initiated and led to a decrease in the mass of the metastasis infiltrating the left atrium. Arterial hypertension caused by sunitinib therapy was effectively controlled by the use of an angiotensin-converting-enzyme inhibitor. Therapy with sunitinib reduced the symptoms of exercise intolerance; the patient felt much better and was able to return to his family and resume professional activity. Further studies are required to confirm the utility of sunitinib therapy in patients with symptoms of heart failure due to heart metastases from RCC. Copyright 2009 S. Karger AG, Basel.