Bilateral Nephroblastoma with Dilated Cardiomyopathy as an Indication for Off-Protocol Treatment: A Case Report

Abstract

Patients with a Wilms tumor are often admitted to the hospital accidentally, with an abdominal mass causing asymmetry of the abdominal wall. Hypertension accompanying a Wilms tumor occurs in about 10–27% of children, but cardiomyopathy associated with a Wilms tumor is very rarely described. This publication presents a case of a 9-month-old girl with a bilateral Wilms tumor accompanied by dilated cardiomyopathy since her initial cancer diagnosis, as well as her off-protocol treatment. The severe condition of the child forced the application of off-protocol treatment, i.e., accelerated resection of a larger tumor, which enabled the improvement of heart performance and made subsequent therapy possible. In the course of the presented treatment, a gradual normalization of cardiac ventricular function and contractility was observed. In conclusion, a massive abdominal tumor associated with abdominal compartment syndrome compromised the functioning of the cardiovascular system in the young child. Therefore, earlier removal of Wilms tumors in patients with heart failure should be considered. This may result in the improvement of cardiovascular function and the possibility of further therapy.

Dilated hypertensive cardiomyopathy in an infant with unilateral Wilms tumor: A case report and literature review

“…5 By reviewing literature, we only found seven cases of WT with DHCm reported in English literature (Table 1). [6][7][8][9][10][11][12] For children aged between 1-and 13-year-old, SBP or DBP ≥95th percentile to <95th percentile + 12 mmHg (on the basis of age, sex and height) is classified as stage 1 HTN, while higher SBP or DBP is classified as stage 2 HTN. 4 The BP values of 95th percentile for infants are distinctive.…”