Related Experiment Videos
Intracardiac extension of Wilms' tumor
C C Patel1, A Rees, S J Bertolone
1University of Louisville, Department of Pediatrics, School of Medicine, Kentucky 40292.
Insights
Wilms tumor, a common childhood abdominal cancer, can extend into the heart. Early cardiac evaluation and aggressive treatment are crucial for improving survival in these rare, high-risk cases.
Area of Science:
- Pediatric Oncology
- Cardiovascular Pathology
Background:
- Wilms tumor is a prevalent pediatric intraabdominal malignancy.
- Primary cardiac tumors are exceedingly rare in children.
- Cardiac metastasis from malignancy typically indicates advanced disease.
Observation:
- Three cases of right-sided Wilms tumor with direct intracardiac extension were documented.
- Cardiac involvement can be the initial presentation of Wilms tumor.
- Prognosis is poor for Wilms tumor with intracardiac extension.
Findings:
- Cardiovascular examination and metastatic workup are essential for abdominal masses suspected to be Wilms tumor.
- Two-dimensional echocardiography is a valuable noninvasive tool for diagnosis and treatment planning.
- Aggressive multimodal therapy (surgery, chemotherapy, radiation) improves survival rates.
Implications:
- Highlights the importance of early cardiac assessment in pediatric abdominal masses.
- Emphasizes the role of echocardiography in managing Wilms tumor with intracardiac extension.
- Underscores the need for aggressive, multidisciplinary treatment strategies for improved outcomes.
Abstract:
Three cases of right-sided Wilms' tumor with direct intracardiac extension are described. Wilms' tumor is one of the most common intraabdominal tumors of childhood. Primary cardiac tumors that arise from myocardium are extremely rare. Metastasis to the heart or pericardium is usually a late complication in the course of a malignancy. In Wilms' tumor cardiac manifestations may be the presenting symptoms at the time of diagnosis. The prognosis for Wilms' tumor with intracardiac extension of the tumor is poor. A thorough cardiovascular examination and a metastatic workup should be done for abdominal masses presumptive of Wilms' tumor. Two-dimensional echocardiography is a noninvasive diagnostic tool, and the information obtained by its use not only allows planning of surgical intervention, chemotherapy, or local radiation therapy, but also is beneficial for long-term follow-up. Aggressive surgery, chemotherapy, and radiation therapy has increased the survival figures of these children.