Wilms' tumours with intracaval involvement

Medical and Pediatric Oncology
V Martínez-IbáñezJ Boix-Ochoa

Abstract

Since Gross established the basic rules for nephrectomy in Wilms' tumour (WT) in 1953, the management of nephroblastoma has been more straightforward. However, some cases with intravascular involvement, currently detected by ultrasound (US), may represent a daunting challenge for the surgeon. Inferior vena cava with tumour thrombus, induced by WT, can be asymptomatic and, if undetected, can contribute to poorer prognosis for two main reasons: possible neoplastic cells inside the thrombus and higher morbidity risk of surgery. From 1979 to 1993, 81 WT were studied by routine US. Intracaval thrombosis was diagnosed in four (5%), in one of which the thrombus extended to the right atrium. In our experience, the surgical strategy in each of the four cases (100% survival) depended on the length of the thrombus and whether or not it infiltrated the vena cava wall. If the thrombus can be easily removed: complete resection. However, in cases of atrial thrombus, and more particularly if the thrombus involves the intima, we suggest the thrombus not be touched since the problem may be solved by preoperative and postoperative chemotherapy. Thus the favourable prognosis would be maintained and superfluous risky surgery avoided.

References

Jul 1, 1992·Journal of Pediatric Surgery·W R ThompsonJ Randolph
Apr 1, 1985·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·N BreslowG J D'Angio
Oct 1, 1982·Journal of Pediatric Surgery·S R LuckR Labotka
Oct 1, 1983·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J LemerleM Carli
Jan 1, 1994·Medical and Pediatric Oncology·S FedericiR Dòmini

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Citations

Jun 23, 2001·Annals of Surgery·R C ShambergerD M Green
May 2, 2002·Medical and Pediatric Oncology·Omer GörgünH Haldun Emiroğlu
Apr 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Suneel N NagdaBahman Emami
May 14, 2005·Journal of Pediatric Hematology/oncology·Canan AkyüzMünevver Büyükpamukçu
Jan 11, 2017·Pediatric Surgery International·Abeer Al DiabKhalil Ghandour
Jun 2, 2004·Pediatric Blood & Cancer·Philipp SzavayJoerg Fuchs

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