The Role of Ultrasonography for Diagnosing Wilms Tumor in Developing Country

Rahmani, Aulia; Sari, Nur Melani; Indriasari, Vita

doi:10.18502/ijhoscr.v15i3.6844

Cited by 2 publications

(2 citation statements)

References 26 publications

(24 reference statements)

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“…WT mostly presents as a painless mass in the upper abdominal quadrant, while hematuria is observed only in fewer than 20% of cases [2]. Diagnosis is typically made at abdominal ultrasound, which reveals a solid mass with smooth margins and may exhibit features such as vascular invasion, necrotic (hypoechoic), cystic (anechoic), and/or hemorrhagic/calcified/fatty (hyperechoic) areas [3]. Computed tomography (CT) during the venous phase provides an in-depth characterization of WT, which appears as a heterogeneous soft-tissue density mass, occasionally displaying calcified or fatty regions [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Prechemotherapy Transperitoneal Robotic‐Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four‐Years‐Old Patient

Della Corte,

Cerchia,

Oderda

et al. 2023

Preprint

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Background: Wilms tumor (WT) is the main renal tumor in children. SIOP-UMBRELLA Guidelines admit Nephron sparing surgery (NSS) in syndromic patients, and in small (&lt;300 ml) nonsyndromic unilateral WTs, without lymph node involvement, and with a substantial expected remnant renal function, after neoadjuvant chemotherapy. We report our prechemotherapy transperitoneal robot-assisted partial nephrectomy (RAPN) in a unilateral non-syndromic Wilms tumor. Methods: A 6-year-old-child showed an exophytic 3.6 cm diameter solid rounding mass involving the upper right renal pole at an incidental abdominal echotomography. CT-scan and abdominal MRI proved no local infiltration neither lymph node involvement was appreciated, suggesting an exophytic mass easily resectable through a NSS robotic approach, with a low risk of rupture and no subverted renal anatomy. The preoperative imaging was not suggestive for WT. A virtual 3D reconstruction of the tumor was performed. Results: the oncologic board approved a robot-assisted partial nephrectomy with the intraperitoneal approach. The histopathologic analysis displayed a WT. The patient underwent 10 vincristine-doses adjuvant chemotherapy. 28-months follow-up showed no tumor recurrence. Conclusions: Intraperitoneal RAPN can represent an opportunity for WT and needs to be assessed as a challenging possibility. This case suggests a potential role of prechemotherapy RAPN in the near future for highly selected patients.

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Section: Introductionmentioning

confidence: 99%

“…In very rare cases, WT can be confused with benign conditions, including pediatric cystic nephroma (typically lacking solid nodular components) [8], renal abscess, hydronephrosis, and angiomyolipoma [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Prechemotherapy Transperitoneal Robotic‐Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four‐Years‐Old Patient

Della Corte,

Cerchia,

Oderda

et al. 2023

Preprint

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Unexpected Huge Prevalence of Intracardiac Extension of Wilms Tumor—A Single Center Experience from a Ugandan Hospital

Mapelli

Ferrara

et al. 2022

Children

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Wilms tumor (WT) is the most common primary renal malignancy in young children. WT vascular extension to the inferior vena cava (IVC) occurs in 4–10% of cases and can reach the right atrium (RA) in 1%. Data on WT clinical presentation and outcome in developing countries are limited. The aim of the present study is to describe the prevalence of intracardiac extension in a consecutive population of WT patients observed in a large non-profit Ugandan hospital. A total of 16 patients with a histological diagnosis of 29 WT were screened in a 6-month period. Patient n°2, a 3 y/o child, presented with a 3-week history of abdominal distension, difficulty in breathing, and swelling of the lower limbs. A cardiovascular system exam showed rhythmic heart sounds, a heart rate of 110 beats per minute, and a pansystolic murmur on the tricuspid area; the abdomen was grossly distended with a palpable mass in the right flank, hepatomegaly, and splenomegaly. An abdomen ultrasound showed an intra-abdominal tumor, involving the right kidney and the liver and extended to the IVC. An ultrasound guided biopsy showed a picture consistent with WT. Cardiac echo showed a huge, mobile, cardiac mass attached to the right side of the interatrial septum, involving the tricuspid valve annulus, causing a “functional” tricuspid stenosis. The patient died of cardiogenic shock 7 days after admission. Patient n°3, a 3 y/o child, presented with analogue symptoms and the same diagnosis. The cardiac echo showed a round mass in the RA. Thirteen more patients were screened with cardiac echo, showing a normal heart picture. In our limited series, we found WT cardiac extension in three patients over 16 (19%). Cardiac echo performed routinely can lead to a better staging, prognostic, and therapeutic assessment. In our setting, the intra-cardiac extension could be more frequent than previously reported and might have prognostic implications.

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The Role of Ultrasonography for Diagnosing Wilms Tumor in Developing Country

Cited by 2 publications

References 26 publications

Prechemotherapy Transperitoneal Robotic‐Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four‐Years‐Old Patient

Prechemotherapy Transperitoneal Robotic‐Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four‐Years‐Old Patient

Unexpected Huge Prevalence of Intracardiac Extension of Wilms Tumor—A Single Center Experience from a Ugandan Hospital

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