Polycythemia: a review article and case report of erythrocytosis secondary to Wilms' tumor

Polycythemia and elevated serum erythropoietin associated with a liver haemangioma

BACKGROUND

Secondary polycythemia is a rare condition, which is usually associated to neoplasia or chronic pulmonary disorders.

CASE REPORT

A 41-year-old man man with no history of liver disease was admitted for erythrocytosis. The paraclinical investigations revealed an increased erythropoietin level in the serum and a voluminous hepatic tumor but its identification was unclear. A liver resection was performed and the histopathological examination concluded that the tumor was a giant cavernous haemangioma with extensive myxoid changes. After surgical resection of the haemangioma, normal haemoglobin and serum erythropoietin were obtained without any further treatment.

CONCLUSION

Liver haemangioma must be included in rare cause of secondary polycythemia, and surgical resection of the haemangioma should be considered as the standard to induce complete remission.

Polycythemia secondary to multiloculated renal cyst in a child

Polycythemia has been reported in association with a variety of pediatric renal neoplasms. The authors present the case of a 10-year-old boy with polycythemia and elevated erythropoietin that resolved after resection of a multiloculated renal cyst. This case also is unusual in the small size of the lesion, 0.5 cm in greatest dimension.

Wilms tumor associated with polycythemia: case report and review of the literature

PURPOSE AND METHODS

A case of polycythemia with a normal serum erythropoietin is described, which led to the diagnosis of Wilms tumor. The clinical features of the reported cases of Wilms tumor associated with polycythemia are reviewed.

RESULTS

An asymptomatic 6-year-old boy with polycythemia, a normal serum erythropoietin, and no evidence of erythroid colony forming activity in his serum was found to have a Wilms tumor. After resection and chemotherapy, he has had no recurrence of either the polycythemia or the Wilms tumor. There have now been 10 cases of Wilms tumor reported: 7 patients were more than 16 years of age, 8 were boys, and 9 were clinical stage I with a favorable histology.

CONCLUSIONS

Polycythemia is a rare manifestation of Wilms tumor that can occur in the absence of an elevated serum erythropoietin and has an association with male gender, older patient age, and low clinical stage. Children with unexplained polycythemia should be investigated for Wilms tumor, even if the serum erythropoietin level is normal.