Wilms tumor in right atrium.

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.