Intra-atrial extension of Wilms' tumor.
Echocardiography in a 4-year-old boy, with nephroblastoma of the left kidney, revealed a large homogenous mass in right atrium extending from inferior vena cava, and protruding through tricuspid valve into right ventricle during diastole. Ultrasonography revealed the contiguous spread of the tumor through renal vein with near total caval occlusion. The patient had a fatal outcome before definite treatment could be started. Intracardiac extension of infradiaphragmatic tumors through caval route, although infrequent, can be seen with renal cell carcinoma, Wilms' tumor, hepatoma, lymphoma, and uterine and adrenal tumors. Detection of a mass in right atrium in a child should alert the echocardiographer about the possibility of caval spread from a renal neoplasm.
Namboodiri
Narayanan
N
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. kknnamboodiri@yahoo.co.in
Krishnamoorthy
K M
KM
Tharakan
J A
JA
D002675:Child, Preschool; D004452:Echocardiography; D017809:Fatal Outcome; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000473:pathology; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology; D009396:Wilms Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging