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World Journal of Surgical Oncology

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Open Access 01-12-2018 | Case Report

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

Authors: Krzysztof Ratajczyk, Adrian Czekaj, Joanna Rogala, Pawel Kowal

Published in: World Journal of Surgical Oncology | Issue 1/2018

Abstract

Background

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.

Case presentation

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.

Conclusions

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 venous tumor thrombus regression. Therefore, percutaneous biopsy should be always considered in young patients presenting with renal tumor invading venous system. IVC ligation is a safe treatment option in the event of complete inferior vena cava occlusion due to distal thrombosis concomitant to tumor thrombus, provided collateral venous pathways are well-developed.

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Title: Adult Wilms tumor with inferior vena cava thrombus and distal deep vein thrombosis – a case report and literature review
Authors: Krzysztof Ratajczyk
Adrian Czekaj
Joanna Rogala
Pawel Kowal
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-018-1343-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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