Right Ventricular Extension of Wilms’ Tumor

Wilms’ tumor is the most common pediatric renal tumor, but cardiac metastases from this tumor are rare. An 8-year–old boy presented with hematuria and lower extremity pain. Computed tomography revealed a left renal mass. In addition, pre-operative echocardiography revealed a large homogenous mass in the right atrium, extending from the inferior vena cava and protruding through the tricuspid valve into the right ventricle. The patient underwent combined radical nephrectomy and removal of the mass from the inferior vena cava and right heart chambers, followed by immunotherapy. Pathology confirmed undifferentiated Wilms’ tumor in both the left kidney and the right heart chambers. The extension of Wilms’ tumor to the great vessels and the heart chambers indirectly affects the final outcome. It seems in most cases, combination surgery and chemotherapy is the choice method of treatment, and the selection of chemotherapy or surgery as the primary line of treatment depends on tumor thrombus extension and the patient’s condition at the time of diagnosis (Iranian Heart Journal 2008; 9 (4): 50 -53).