Wilms tumor with dilated cardiomyopathy: A case report

Abstract

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.

Extrarenal Wilms tumor with hypertension and dilated cardiomyopathy in an infant: A report of an unusual case

“…WT1 is the most sensitive immunohistochemical marker for Wilms tumor diagnosis, being detectable in >90% of cases. 9 To date, there have only been six published cases of Wilms tumor patients suffering from hypertensive cardiomyopathy and subsequent CHF, [10][11][12][13][14][15] with all of these cases being tied to primary intrarenal the production of renin by these tumors is the primary driver of hypertension. 16 In the present case, preoperative renin levels were significantly elevated but rapidly returned to normal ranges within the days following surgery.…”

“…To date, there have only been six published cases of Wilms tumor patients suffering from hypertensive cardiomyopathy and subsequent CHF, 10–15 with all of these cases being tied to primary intrarenal tumors. This report is the first to describe hypertension and CHF in a patient with an ERWT.…”

A Cardiac Approach to Wilms Tumor with Tumor Thrombus Extension to the Right Atrium Without Cardiopulmonary Bypass: A 5-Year Follow-up

“…The patients in stages II and IV occasionally present with IVC obstruction or congestive cardiac failure, in which case the outcome will be catastrophic (5,6) and when they present with heart failure, the outcome is often not good (7). Wilms' tumor or intravenous thrombus is not clinically common in children (8).…”

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

“…After chemotherapy and tumor removal, heart function improved [ 7 ]. Sethasathien et al also reported that cardiac activity normalized after Wilms tumor resection despite chemotherapy and radiation therapy [ 13 ]. Parry et al presented a case of a child with cardiomyopathy and unilateral Wilms tumor without hypertension, but with an elevated level of renin and angiotensin.…”