Metastatic tumor involvement of the left atrium via the pulmonary veins has been reported rarely. We report a 58-year-old patient with renal cell carcinoma metastatic to the left atrium via the pulmonary veins and the lower lobe of the left lung. An unusual surgical approach combining median sternotomy and videoscope-assisted thoracic surgery was used in resecting the atrial mass and performing a lower lobe resection.