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Related Experiment Videos

[Wilms' tumors with intra-cava infiltration]

V Martínez Ibáñez1, J Sánchez de Toledo, M de Diego

  • 1Departamento de Cirurgía Pedíatrica, Hospital Universitario Materno Infantil, Barcelona.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|October 1, 1995
PubMed
Summary

Wilms' tumour (WT) with inferior vena cava thrombus requires careful surgical consideration. Chemotherapy may be preferred over surgery for atrial thrombus to avoid high morbidity and maintain favorable prognosis.

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Area of Science:

  • Pediatric Oncology
  • Surgical Oncology
  • Diagnostic Imaging

Context:

  • Wilms' tumour (WT) management has evolved since 1953.
  • Intravascular extension, particularly inferior vena cava (IVC) thrombus, presents surgical challenges.
  • Ultrasound (US) is crucial for detecting intracaval involvement.

Purpose:

  • To evaluate the diagnostic utility of ultrasound in detecting IVC thrombus in WT.
  • To assess surgical strategies for WT with IVC thrombus.
  • To determine optimal management for intracaval tumour thrombus based on extent and infiltration.

Summary:

  • Routine ultrasound identified intracaval thrombosis in 5% of 81 WT cases studied.
  • Surgical approach depended on thrombus length and IVC wall infiltration.

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  • For extensive or intimal-involving thrombi, non-operative management with chemotherapy was favored, achieving 100% survival.

    • Impact:

    • Highlights the importance of preoperative imaging for surgical planning in WT.
    • Suggests a tailored approach to IVC thrombus management, balancing surgical risk and oncologic outcomes.
    • Demonstrates the efficacy of chemotherapy in managing complex WT cases with IVC involvement, potentially avoiding high-risk surgery.