Key result
Neoadjuvant chemotherapy successfully reduced the right atrial tumor burden in a 4-year-old girl with nephroblastoma, allowing for successful radical nephrectomy.
Why the study?
Cardiac metastasis of nephroblastoma carries a worse prognosis, and echocardiography is useful for diagnosing cardiac masses but is not routine without cardiac features.
Case Report (n=1)
No
Routine transthoracic echocardiography is recommended for all patients with nephroblastoma to detect rare but potentially fatal intracardiac metastasis, which can be effectively managed with neoadjuvant chemotherapy prior to surgery.
Supports neoadjuvant chemotherapy feasibility in rare pediatric nephroblastoma with atrial extension; hypothesis-generating and should not yet change practice.
Two-dimensional echocardiography is useful in the diagnosis of cardiac masses, including tumors. Cardiac metastasis of nephroblastoma heralds a worse prognosis. This 4-year-old child presented with clinical and radiological features suggestive of nephroblastoma. She had intracaval spread of the tumor to the right atrium. The cardiac metastasis was initially missed as echocardiography was not part of the routine workup for the patient as she had no clinical features suggestive of cardiac disease. Although cardiac metastasis of nephroblastoma is rare, we recommend routine transthoracic echocardiography for all patients irrespective of the presence of cardiac symptoms and signs.
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Umuerri et al. (2021) conducted a case report in Nephroblastoma with right atrial extension (n=1). Neoadjuvant chemotherapy and radical nephrectomy was evaluated on Tumor burden reduction and surgical outcome. Neoadjuvant chemotherapy successfully reduced the right atrial tumor burden in a 4-year-old girl with nephroblastoma, allowing for successful radical nephrectomy.
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