Intracardiac extension of Wilms' tumour: demonstration by magnetic resonance

Extension of intravascular tumour thrombus into the right atrium is a well recognized but rare complication of Wilms' tumour (Ritchey et al, 1988). We described the first such case demonstrated by Magnetic Resonance (MR) imaging. A 5-year-old girl was admitted to hospital with a 1-month history of lethargy and one episode of haematuria. Physical examination revealed a large mass in the right loin and elevation of the jugular venous pressure. Abdominal ultrasound demonstrated a 10 cm echogenic, right renal mass. The inferior vena cava (IVC) was expanded by intraluminal thrombus which extended up to the right atrium. Computerized tomography (CT) confirmed a right renal mass and caval thrombus.