Related Experiment Video
Updated: Aug 13, 2026
Utilization of Ultrasound Guided Tissue-directed Cellular Implantation for the Establishment of Biologically Relevant Metastatic Tumor Xenografts
Published on: May 25, 2018
Visceral larval migrans masquerading as metastatic disease in a toddler with Wilms tumor
Andrew Anderson1, Lynn Ansley Fordham, Melania L Bula
1Department of Radiology, University of North Carolina School of Medicine, 3325 Old Infirmary Bldg., Campus Box 7510, Chapel Hill, NC 27599-7510, USA. fdh@med.unc.edu
Insights
Toxocariasis, a parasitic infection, can mimic metastatic disease in children with Wilms tumor, presenting as liver and lung lesions. Early diagnosis and consideration of this rare differential are crucial for appropriate management.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Radiology
Background:
- Wilms tumor is a common pediatric kidney cancer.
- Metastatic disease is a common complication of Wilms tumor.
- Pulmonary nodules and liver lesions can indicate metastatic Wilms tumor.
Observation:
- A child with Wilms tumor presented with pulmonary nodules.
- After treatment, new liver lesions and pulmonary nodules appeared.
- Lung biopsy showed granulomas with eosinophils, and elevated Toxocara canis antibody titers were detected.
Findings:
- The patient's presentation mimicked metastatic Wilms tumor.
- Toxocariasis was identified as the underlying cause of the lesions.
- Peripheral eosinophilia was a key indicator.
Implications:
- Toxocariasis is a rare but important differential diagnosis in children with Wilms tumor and unexplained liver/lung lesions.
- This case highlights the need for considering parasitic infections in pediatric oncology.
- Multifocal peripheral pulmonary opacities and liver lesions in this context warrant investigation for toxocariasis.
Abstract:
A 22-month-old girl with a renal mass had multiple small pulmonary nodules on CT at her initial presentation. After biopsy and neoadjuvant chemotherapy, a Wilms tumor was resected and the pulmonary nodules were shown to have regressed on CT. Follow-up imaging 4 months after initial diagnosis demonstrated multiple new liver lesions and new pulmonary nodules with peripheral eosinophilia. Lung biopsy revealed granuloma formation with prominent eosinophils. The serum antibody titers for Toxocara canis were elevated. This case illustrates that toxocariasis should be considered as a rare differential diagnostic possibility for multiple liver lesions and multifocal peripheral pulmonary opacities in young children with Wilms tumor.
