Bahrami Children Hospital Tehran University of Medical Sciences - PowerPoint PPT Presentation

Bahrami Children Hospital Tehran University of Medical Sciences

Thrombosis in Wilm ’ s Tumor M.A.Ehsani Pediatrician,Hem.&Onc. Bahrami Hospital Tehran university of Medical Sciences XII – IPHOS Congress 1398/6/27 Urmia

Introduction: • Wilm's tumor and renal cell carcinoma are the most common of renal thrombosis. • lymphomas, primary renal Burkitt lymphoma (BL) is rare.

• Surgery is the most prognostic factor in Wilm's tumor outcome.

Case1: • 7 years old girl • Abdominal mass in July 2009(Mordad1388). • Tumor thrombi was extend from right kidney to renal vein , inferior vena cava , right atrium and present in right ventricle . •

Case1( Continue): • The kidney biopsy is done on 19 th August 2009 (1388/05/28). • Pathology report was Wilm ’ s tumor Favorable histology. • Protocol NWTS-4( D-4A) was began.

Case1( Continue): • Total right nephrectomy and thrombectmy was performed on19th October 2009(1388/07/27) with coupling of Pediatric surgeon and Heart Surgeon.

Case1( Continue): • Radiotherapy and chemotherapy continued till 26 th September 2010( 1389/07/04). • At present the patient is free of tumor

Case2: • A 4 years old boy who referred with clot in urine and fever was admitted as UTI. • Left renal mass is detected with renal vein thrombosis.

Case2( Continue): • Total left nephrectomy and thrombectmy was performed on7th July 2017(1396/04/16) with coupling of Pediatric surgeon and Vascular Surgeon. • Protocol NWTS-4( D-4A) was began at the time of

Case2( Continue): • The first Pathology report was Renal Cell Carcinoma.

Case2( Continue): • The first Pathology report was Renal Cell Carcinoma. • The review of Pathology report was Wilm’s tumor Rhabdoid type (Unfavorable histology).

Case2( Continue): • After the pathology report the ICE and VDC protocol substituted. • Chemotherapy continued till 7 th May 2018 (1397/2/17). • At present the patient is free of tumor.

Case3: • A 2.5 years old boy who referred with Left abdominal mass. • Tumor thrombi was extend from right kidney to renal vein , inferior vena cava , right atrium .

Case3( Continue): • مکش یفارگونوس شرازگ : • لقادح داعبا اب گرزب رایسب هدوت (129 رد 95 رتمیلیم ) لحم زا هک کیتسیس تارییغت یواح نژورته دیلاس ا هتفای شرتسگ نگل تمس هب پچ هیلک کیموتانآ و تس چ هیلک یناتحت لپ میشناراپ زا یشخب نآ رانک رد هدید پ دوشیم . • ب شرتسگ اب یناتحت فوجا دیرو لاروموت زوبمورت ه دوشیم تیور تسار زیلهد .

Case3( Continue): • Total left nephrectomy was performed on14th April 2019(1398/1/25). • Pathology report was Wilm’s tumor favorable histology. • High risk Wilm's tumor protocol was began at the time of nephrectomy.

Case3( Continue): • After nephrectomy, massive ascitis and pleural effusion and hypo-albuminemia were present which did not response to albumin administration.

Case3( Continue): • Total right nephrectomy and thrombectmy was performed on 27 th May 20019(1398/03/06) with coupling of Pediatric surgeon and vascular Surgeon.

Case3( Continue): • After nephrectomy and thrombectmy , the patient condition is good . • Ascitis and pleural effusion are disapeared. • At present the treatment will be continued.

Thanks for you Attention