Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
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:
Clinical Differential Diagnosis:
Recurrent Wilms tumor
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.
Images 2 and 3
Imaging Differential Diagnosis:
The patient underwent a thoracotomy and both lesions were removed.
Pathological examination of the surgical specimen showed both lesions to be metastatic Wilms tumor involving the lung and visceral pleura.
Metastases, Pulmonary from Wilms Tumor
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. The patient restarted chemotherapy.
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