Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Clinical History:
The patient was a 13 year old female who had recently developed
fatigue and malaise. Past medical history was remarkable for having
had bilateral Wilms tumors at age 6 months, treated by left partial
nephrectomy and right total nephrectomy.
Clinical Physical Exam:
Unremarkable
Clinical Labs:
Non-contributory
Clinical Differential Diagnosis:
Recurrent Wilms tumor
Imaging Findings:
A chest film showed a soft tissue density in the right cardiophrenic
angle. A chest CT exam demonstrated that initial mass, and a second
one in the azygo-esophageal recess.
Imaging Differential Diagnosis:
Metastatic disease
Operative Findings:
The patient underwent a thoracotomy and both lesions were removed.
Pathological Findings:
Pathological examination of the surgical specimen showed both lesions
to be metastatic Wilms tumor involving the lung and visceral pleura.
Final Diagnosis:
Metastases, Pulmonary from Wilms Tumor
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. The patient
restarted chemotherapy.
Similar Cases:
Case 43
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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