Adult Wilms tumor: Case report

V Morabito; N Guglielmo; F Melandro; G Mazzesi; F Alesini; S Bosco; P B Berloco

doi:10.1016/j.ijscr.2014.06.021

Adult Wilms tumor: Case report

Int J Surg Case Rep. 2015:6C:273-6. doi: 10.1016/j.ijscr.2014.06.021. Epub 2014 Dec 8.

Authors

V Morabito¹, N Guglielmo², F Melandro³, G Mazzesi⁴, F Alesini⁵, S Bosco⁶, P B Berloco⁷

Affiliations

¹ Department "Paride Stefanini", General Surgery and Organ Transplant, Sapienza University of Rome, Italy. Electronic address: vemorabito@gmail.com.
² Department "Paride Stefanini", General Surgery and Organ Transplant, Sapienza University of Rome, Italy. Electronic address: nicola.guglielmo@libero.it.
³ Department "Paride Stefanini", General Surgery and Organ Transplant, Sapienza University of Rome, Italy. Electronic address: fabio.melandro@uniroma1.it.
⁴ Department of CardioSurgery and Heart Transplant, Sapienza University of Rome, Italy. Electronic address: giuseppe.mazzesi@uniroma1.it.
⁵ Department of Molecular Medicine, Sapienza University of Rome, Italy. Electronic address: francescoalesini@live.it.
⁶ Department of Molecular Medicine, Sapienza University of Rome, Italy. Electronic address: sandro.bosco@uniroma1.it.
⁷ Department "Paride Stefanini", General Surgery and Organ Transplant, Sapienza University of Rome, Italy. Electronic address: pasquale.berloco@uniroma1.it.

Abstract

Wilms tumor (WT) occurs infrequently in adults. Even rarer is adult WT with extension by direct intravascular spread into the right side of the heart. The present report describes a WT with intracaval and intracardiac extension in a 38-year-young man. In addition, thrombus extension above the infrahepatic IVC represents a major technical topic for surgeons because of the possible occurrence of uncontrollable hemorrhages and tumor fragmentation. We report the results of a surgical approach to caval thrombosis including the isolation of the IVC from the liver as routinely performed during liver harvesting. The morphologic and immune-histochemical findings confirmed the diagnosis.

Keywords: Caval thrombosis; Intracardiac extension; Nephrectomy; Wilmor tumors.