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Only 4-6% of children with renal tumor show inferior vena caval or right atrial infiltration at presentation. Tumor emboli are even rarer, and so far, sudden death as the presenting symptom has only been described at presentation in Wilms' tumor in eight cases. We report a unique case of Wilms' tumor that presented with small pulmonary emboli and immediately after as that was diagnosed before death by detection of small emboli and immediately after sudden death as massive pulmonary embolism. It seems that in cases of invasive vascular infiltration with a stable hemodynamic condition at diagnosis immediate surgery may be necessary.

Recurrent pulmonary tumoral embolism and sudden death as the presenting symptom of Wilms' tumor