Nephroblastoma with Right Atrial Extension

Two-dimensional echocardiography is useful in the diagnosis of cardiac masses, including tumors. Cardiac metastasis of nephroblastoma heralds a worse prognosis. This 4-year-old child presented with clinical and radiological features suggestive of nephroblastoma. She had intracaval spread of the tumor to the right atrium. The cardiac metastasis was initially missed as echocardiography was not part of the routine workup for the patient as she had no clinical features suggestive of cardiac disease. Although cardiac metastasis of nephroblastoma is rare, we recommend routine transthoracic echocardiography for all patients irrespective of the presence of cardiac symptoms and signs.