Wilms tumor with dilated cardiomyopathy: A case report

Area of Science:

• Pediatric Oncology
• Cardiology
• Nephrology

Background:

• Wilms tumor is the most common pediatric renal malignancy, typically presenting between ages 2-5.
• Usual Wilms tumor signs include abdominal mass, hypertension, and hematuria.
• This case highlights an atypical presentation involving dilated cardiomyopathy and hypertension secondary to the tumor.

Observation:

• A 3-year-old boy presented with irritability, poor appetite, and respiratory distress.
• Clinical signs included dyspnea, tachycardia, hypertension, and a left upper quadrant abdominal mass.
• Elevated cardiac biomarkers and echocardiography revealed dilated cardiomyopathy with reduced ejection fraction.

Findings:

• Computed tomography confirmed a left renal mass and lung nodules, leading to a Wilms tumor diagnosis.
• The patient received neoadjuvant chemotherapy, radical nephrectomy, radiotherapy, and adjuvant chemotherapy.
• Post-treatment, the patient's blood pressure and left ventricular function normalized.

Implications:

• Dilated cardiomyopathy and hypertension in children can be indicative of Wilms tumor.
• Multimodal treatment involving chemotherapy, surgery, and radiotherapy is effective.
• Prompt diagnosis and intervention are crucial for successful management of pediatric Wilms tumor.