A 2-year-old child had an abdominal mass, a systolic murmur, and electrocardiographic evidence of right atrial overload. An intravenous pyelogram and an inferior vena cavagram demonstrated a Wilms tumor of the right kidney with vena caval obstruction. At operation a caval thrombus could not be dislodged from the abdomen and required a right atriotomy with cardiopulmonary bypass to remove the lesion. This lesion should be suspected in children with Wilms tumor, vena caval obstruction, and cardiac murmurs.
Murphy DA, Rabinovitch H, Chevalier L, Virmani S. Wilms Tumor in Right Atrium. Am J Dis Child. 1973;126(2):210-211. doi:10.1001/archpedi.1973.02110190184015