Surgical management and outcomes of 12 cases of Wilms tumour with intracardiac extension from a single centre

S, Cox; Davidson, Alan; Thomas, Jenny; Brooks, Andre; Hewitson, John; Numanoglu, Alp; Millar, Alastair J. W.

doi:10.1007/s00383-017-4197-x

Cited by 26 publications

(35 citation statements)

References 24 publications

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“…Wilms tumor is characterized by a tendency to invade blood vessels. Extension of a tumor thrombus along the renal vein into the inferior vena cava and right atrium occurs in 4%-10% of all patients with Wilms tumor[11-13]. In the present case, the thrombus was noted in the left renal vein and a pulmonary embolism developed in the left descending artery supplying basal segments of the left lower lobe.…”

Section: Discussionmentioning

confidence: 51%

“…On the other hand, pheochromocytoma could also be suspected in a patient with acute myocarditis or dilated cardiomyopathy and hypertension[7-10]. Intracaval and intracardiac extension of the tumor thrombus is a cardiovascular complication occurring in 4%-10% of Wilms tumor[11-13]. This report describes a pediatric case of Wilms tumor with an unusual presentation of dilated cardiomyopathy with hypertension that was determined to be secondary to the tumor.…”

Section: Introductionmentioning

confidence: 99%

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Wilms tumor with dilated cardiomyopathy: A case report

Sethasathien¹,

Choed-Amphai²,

Saengsin³

et al. 2019

WJCO

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BACKGROUND Wilms tumor is the most common renal malignancy in childhood. It occurs primarily between the ages of 2 and 5 years. The usual manifestations are abdominal mass, hypertension, and hematuria. The case presented here had an unusual presentation, with dilated cardiomyopathy and hypertension secondary to the Wilms tumor. CASE SUMMARY A 3-year-old boy presented with a 5-d history of irritability, poor appetite, and respiratory distress. His presenting clinical symptoms were dyspnea, tachycardia, hypertension, and a palpable abdominal mass at the left upper quadrant. His troponin T and pro-B-type natriuretic peptide levels were elevated. Echocardiography demonstrated a dilated hypokinetic left ventricle with an ejection fraction of 29%, and a suspected left renal mass. Computed tomography scan revealed a left renal mass and multiple lung nodules. The definitive diagnosis of Wilms tumor was confirmed histologically. The patient was administered neoadjuvant chemotherapy and underwent radical nephrectomy. After surgery, radiotherapy was administered, and the adjuvant chemotherapy was continued. The blood pressure and left ventricular function normalized after the treatments. CONCLUSION Abdominal mass, dilated cardiomyopathy and hypertension can indicate Wilms tumor in pediatric patients. Chemotherapy and tumor removal achieve successful treatment.

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Section: Discussionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Wilms tumor with dilated cardiomyopathy: A case report

Sethasathien¹,

Choed-Amphai²,

Saengsin³

et al. 2019

WJCO

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“…Postoperative cardiac complications such as dysrhythmia, venous thromboembolisms, bleeding, or infection may complicate this major surgery and require immediate recognition and management [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The management plan for these cases requires a multidisciplinary approach that may include pediatric cardiology, cardiac surgeon, general pediatric surgeon, urologist, and pediatric oncology. Furthermore, using TEE preoperatively and intra-operatively is very helpful to evaluate vascular tumor extension and to ensure complete resection during surgery with no residual intracardiac thrombus [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of Wilms’ tumor with intracardiac extension: Report of two cases with review of literature

Altwaeel¹,

Kabbani²,

Shammari³

et al. 2020

Journal of the Saudi Heart Association

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Wilms' tumor (WT) is one of the solid tumor that affects children. It involves the kidney and may extend to the lungs and liver. WT conquers the adjacent blood vessels such as renal veins and inferior vena cava (IVC); its extension to IVC and right-sided heart chambers is unusual. Furthermore, when the tumor extends to heart chambers, its surgical management becomes challenging and demands multidisciplinary medical and surgical specialties including pediatric cardiac surgery. In this report, we discuss the surgical management and perioperative treatment of two unusual cases of WT with IVC and intracardiac extension.

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“…While WT is the most common kidney malignancy in children with a yearly incidence of about 1 per 100,000, intravascular manifestation is a rarity, occurring in only about 3 to 10% of WT cases [1]. About a third of these reach the right cardiac atrium and only singular cases have been reported to reach beyond the tricuspid valve into the right cardiac ventricle [2, 3, 4, 5], making it even rarer than bilateral WT, which occurs in 4–13% of patients [6]. The rarity of this condition is especially underlined by the SIOP93–01 and SIOP2001 studies (Societe internationale D'oncologie pediatrique): Of a total number of 1,151 patients with 33 exhibiting intravascular WT growth, not a single case extended to the right cardiac ventricle [1].…”

Section: Introductionmentioning

confidence: 99%

Intracardiac Extension of Wilms Tumor: A Case of a 2.5-Year-Old Girl Presenting with Upper Venous Congestion Caused by Tumor Growth into the Right Cardiac Ventricle

et al. 2019

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While Wilms tumors (WT) typically present solely with an abdominally palpable mass, rare cases exhibiting vascular tumor growth can also present with circulatory problems. Here, we report the case of a 2.5-year-old girl presenting with upper venous congestion and arterial hypertension as the primary symptoms of intraventricular tumor growth exhibiting remarkable tubular and perfused morphology. Clinical situation stabilized after initiation of neoadjuvant chemotherapy (NAC) with actinomycin D and vincristine, followed by surgical resection via laparotomy and sternotomy supported by cardiopulmonary bypass and deep hypothermia. Our results highlight the previously reported feasibility of this approach, even in primarily unstable patients.

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Surgical management and outcomes of 12 cases of Wilms tumour with intracardiac extension from a single centre

Cited by 26 publications

References 24 publications

Wilms tumor with dilated cardiomyopathy: A case report

Wilms tumor with dilated cardiomyopathy: A case report

Perioperative management of Wilms’ tumor with intracardiac extension: Report of two cases with review of literature

Intracardiac Extension of Wilms Tumor: A Case of a 2.5-Year-Old Girl Presenting with Upper Venous Congestion Caused by Tumor Growth into the Right Cardiac Ventricle

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