Adult Wilms tumor with inferior vena cava thrombus and distal deep vein thrombosis - a case report and literature review

World Journal of Surgical Oncology
Krzysztof RatajczykPawel Kowal

Abstract

Adult Wilms tumor (WT, nephroblastoma) is a rare, but well-described renal neoplasm. Although inferior vena cava tumor thrombosis is present in up to 10% of Wilms tumors in childhood, only few cases of this clinical manifestation in adults have been reported. To the best of our knowledge, this is the first case of adult WT infiltrating into inferior vena cava (IVC) with concomitant distal deep vein thrombosis. A 28-year-old male patient with gross hematuria and right flank pain was diagnosed with right kidney tumor penetrating to IVC. Preoperatively, acute distal thrombosis in inferior vena cava and lower extremities veins occurred. Right radical nephrectomy with tumor thrombectomy via cavotomy was performed. In order to prevent pulmonary embolism, IVC was ligated below left renal vein level. Histopathological examination revealed a triphasic nephroblastoma without anaplastic features. Postoperatively, patient was diagnosed with metastatic liver disease, which was treated with two lines of chemotherapy followed by radiotherapy with achievement of complete response. Adult WT occurs usually in young patients, under 40 years of age. Neoadjuvant chemotherapy proved to be effective in children, resulting with tumor shrinkage and ven...Continue Reading

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Citations

Jul 17, 2021·Curēus·Camilo Vallejo YepesRicardo Bruges
Dec 1, 2020·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Jun KuwabaraYuji Watanabe

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