title: Sarcomatous Wilms tumor associated with consumption coagulopathy.
abstract: This is a case report of a sarcomatous Wilms tumor complicating disseminated intravascular coagulation with gastrointestinal bleeding, ascites, pleural effusion, and hepatitis after the second course of actinomycin D. A sarcomatous Wilms tumor is believed to have an unfavorable prognosis even if multimodal therapy is given. Arteriovenous fistulae which we created for purposes of chemotherapy and hyperalimentation by microvascular-sleeve anastomosis functioned well for three years in spite of repeated punctures.
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D002675:Child, Preschool; D003609:Dactinomycin / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000628:therapy; D008297:Male; D010289:Parenteral Nutrition, Total; D014750:Vincristine / Q000627:therapeutic use; D009396:Wilms Tumor / Q000150:complications* / Q000628:therapy
chemical_list: D003609:Dactinomycin; D014750:Vincristine