Wilms' tumour presenting as a pulmonary embolism

Wilms' tumour (nephroblastoma) is one of the most common solid malignant tumours in infancy and childhood. In about 40% of cases, invasion of the renal vein is present. Rarely, these tumours extend into the inferior vena cava and right atrium. We discuss a 7-week-old girl who presented with acute massive pulmonary embolism, and was found to have a large tumour of the left kidney. Later on, the diagnosis of Wilms' tumour was confirmed. Wilms' tumour presenting as massive pulmonary embolism is extremely rare; to our knowledge this is the fourth case described in literature. We review the cases previously described, and comment on the diagnostic and therapeutic features of this clinical entity.