Radionuclide angiography: as diagnostic method for Wilms' tumor with direct extension into the heart

Radioisotope angiography may be used as an initial study in Wilms' tumor. We report a patient who had a total nephrectomy but then had severe cardiovascular complications. These led to open heart surgery and removal of a tumor lodged in the right atrium. Radioisotope angiography, performed two weeks earlier, showed a "cold" image on the anterior wall of the right ventricle. This finding was later confirmed by other studies and finally at the time of a second operation. The purpose of this paper is to discuss the different methods employed in this case, to emphasize the risks attributed to each, and finally to suggest the use of non-invasive studies such as radioisotope angiography as a practical method of study in infancy.