Children Are Great Imitators. So Give Them Something Great To Imitate
Giant abdominal neuroblastoma in 6 months old baby
Published on: 2020-03-30
Background: Abdominal tumor is one of the most challenge pathology in pediatric surgery. The pediatric surgeon must deal with clinical cases where the size of the tumor or its penetration into neighboring anatomical structures should be well clinically evaluated before the intervention. Caution should be exercised especially in avoiding inferior timing and timing of inferior vena cava where the latter is infiltrated.
Case presentation: 6 months old baby is consulted by our team. From several days, parents has palpated a big mass in abdomen. CT scan shows a very big mass, 7 x 7 cm, which is in close relation with the right kidney. Vena cava is infiltrated by the tumor. The treatment plan was at least excisional biopsy, or total resections of the tumor. Operation: Right side transversal laparotomy extended on the left side. The very big mass which is located on hilum of right kidney but without infiltrated kidney. Mass has infiltrate Vena cava. Right renal vein was infiltrated. The mass is dissected free from all the part. Part of wall of VC is resected. The right venal vein is occluded from the mass and part of the dissection. The viability of the right kidney is preserved from collateral vascularity.
Conclusions: In big abdominal tumor when vena cava is infiltrated, several imported principle mast kept in mind when undertaking vena cava resection. Resection of inferior vena cava can be done safely, because an extensive collateral venous supply will have developed in most cases. With right-sided kidney tumors, resection of the suprarenal vena cava is also possible provided the left renal vein is ligated distal to the gonadal and adrenal tributaries, which then provided collateral venous drainage from the left kidney.