Bilateral Nephroblastoma with Dilated Cardiomyopathy as an Indication for Off-Protocol Treatment: A Case Report

Patrycja Sosnowska-Sienkiewicz, Ewelina Gowin, Katarzyna Jończyk-Potoczna, Przemysław Mańkowski, Jan Godziński and Danuta Januszkiewicz-Lewandowska
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Patrycja Sosnowska-Sienkiewicz: Department of Pediatric Surgery, Poznan University of Medical Sciences, 60-572 Poznan, Poland
Ewelina Gowin: Department of Health Promotion, Poznan University of Medical Sciences, 60-572 Poznan, Poland
Katarzyna Jończyk-Potoczna: Department of Pediatric Radiology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
Przemysław Mańkowski: Department of Pediatric Surgery, Poznan University of Medical Sciences, 60-572 Poznan, Poland
Jan Godziński: Department of Pediatric Traumatology and Emergency Medicine, Wroclaw Medical University, 50-041 Wroclaw, Poland
Danuta Januszkiewicz-Lewandowska: Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland

IJERPH, 2020, vol. 17, issue 24, 1-6

Abstract: Patients with a Wilms tumor are often admitted to the hospital accidentally, with an abdominal mass causing asymmetry of the abdominal wall. Hypertension accompanying a Wilms tumor occurs in about 10–27% of children, but cardiomyopathy associated with a Wilms tumor is very rarely described. This publication presents a case of a 9-month-old girl with a bilateral Wilms tumor accompanied by dilated cardiomyopathy since her initial cancer diagnosis, as well as her off-protocol treatment. The severe condition of the child forced the application of off-protocol treatment, i.e., accelerated resection of a larger tumor, which enabled the improvement of heart performance and made subsequent therapy possible. In the course of the presented treatment, a gradual normalization of cardiac ventricular function and contractility was observed. In conclusion, a massive abdominal tumor associated with abdominal compartment syndrome compromised the functioning of the cardiovascular system in the young child. Therefore, earlier removal of Wilms tumors in patients with heart failure should be considered. This may result in the improvement of cardiovascular function and the possibility of further therapy.

Keywords: cardiomyopathy; children; cardiotoxicity; hypertension; Wilms tumor (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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