Abstract
Wilms tumor typically presents as an abdominal mass, though occasionally patients present with other manifestations. We report a case of a child presenting with a perirenal hemorrhage and an initially occult Wilms tumor, found only on subsequent renal arteriography. Symptoms in this patient were caused by the presence of perirenal and subcapsular hemorrhage rather than the tumor itself. Despite an unusual presentation, we need to consider underlying neoplasia in children with renal hemorrhage and the absence of a history of trauma. Follow-up studies might help clarify initial negative imaging results.
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References
Baig MR, Abulaban M, Seeler RA (1981) Radiological case of the month: Wilms’ tumor with massive subcapsular hemorrhage. Am J Dis Child 135:267–268
Ramsay KC, Dehner LP, Coccia PE, et al (1977) Acute hemorrhage into Wilms’ tumor. J Pediatr 91:763–765
Hanquinet S, Annoshiravani M, Poletti PA, et al (1998) Massive spontaneous perirenal hematomas in children: radiologic pitfalls in differentiating between benign and malignant lesions. Med Pediatr Oncol 31:173–174
Belville JS, Morgentaler A, Loughlin KR, et al (1989) Spontaneous perinephric and subcapsular renal hemorrhage: evaluation with CT, US, and angiography. Radiology 172: 733–738
Erdag N, Dicle O, Igci E, et al (1999) Subcapsular hemorrhage of adult Wilms’ tumor. Clin Imaging 23:44–46
Geller E, Smergel EM, Lowry PA (1997) Renal neoplasms of childhood. Radiol Clin North Am 35:1391–1413
Leung RS, Liesner R, Brock P (2004) Coagulopathy as a presenting feature of Wilms tumour. Eur J Pediatr 163:369–373
Thyss A, Taviere V, Quintana E, et al (1990) Spontaneous hematoma of the kidney simulating a nephroblastoma. Report of two cases. Am J Pediatr Hematol Oncol 12:355–358
Brkovic D, Moehring K, Doersam J, et al (1996) Aetiology, diagnosis and management of spontaneous perirenal hematomas. Eur Urol 129:302–307
Meng CH, Elkin M (1969) Angiographic manifestations of Wilms’ tumour. Am J Roentgenol Radium Ther Nucl Med 105:95–104
Cremin BJ, Kaschula ROC (1972) Arteriography in Wilms’ tumour – the results of 13 cases and comparison to renal dysplasia. Br J Radiol 45:415–422
Fellows KE (1972) The uses and abuses of abdominal and peripheral arteriography in children. Radiol Clin North Am 10:349–366
Gooding CA, Raslavicius PA (1965) Arteriographic demonstration of perirenal hematoma and Wilms’ tumor in a hypertensive child. Am J Roentgenol Radium Ther Nucl Med 93:467–472
McKenzie KJ, Ferrier RK, Howatson AG, et al (1996) Demonstration of renin gene expression in nephroblastoma by in situ hybridization. J Pathol 180:71–73
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Byerly, D., Coley, B. & Ruymann, F. Perirenal hemorrhage as first presentation of Wilms tumor. Pediatr Radiol 36, 714–717 (2006). https://doi.org/10.1007/s00247-006-0168-4
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DOI: https://doi.org/10.1007/s00247-006-0168-4