Intracardiac extension of Wilms' tumor.

Three cases of right-sided Wilms' tumor with direct intracardiac extension are described. Wilms' tumor is one of the most common intraabdominal tumors of childhood. Primary cardiac tumors that arise from myocardium are extremely rare. Metastasis to the heart or pericardium is usually a late complication in the course of a malignancy. In Wilms' tumor cardiac manifestations may be the presenting symptoms at the time of diagnosis. The prognosis for Wilms' tumor with intracardiac extension of the tumor is poor. A thorough cardiovascular examination and a metastatic workup should be done for abdominal masses presumptive of Wilms' tumor. Two-dimensional echocardiography is a noninvasive diagnostic tool, and the information obtained by its use not only allows planning of surgical intervention, chemotherapy, or local radiation therapy, but also is beneficial for long-term follow-up. Aggressive surgery, chemotherapy, and radiation therapy has increased the survival figures of these children.