Case Report: Pleural effusion in Wilms tumor - always malignant?

Wilms tumor (WT) is the most common renal malignancy seen in pediatric patients. Although lungs are the most common site of metastasis in Wilms tumor, non-malignant pleural effusion has been infrequently reported. Here, we report a case of an eleven-year-old female who presented with an abdominal mass and progressive breathlessness. On further evaluation, she was found to have a right-sided Wilms tumor with ipsilateral massive pleural effusion. The effusion resolved almost completely after four weeks of chemotherapy. We conclude that patients suffering from Wilms tumor presenting with pleural effusion need not be synonymous with metastatic disease and can have a favorable prognosis.

A protocol for the development of PhyCaRe: An extension of the CARE guideline for physiotherapy using the Delphi method.

Background: Case reports are one of the important forms of documentation and publication of clinical physiotherapy presenting the first line of evidence in scientific literature. In order to provide a systematic and precise structure for reporting and presenting cases, the CARE guidelines were established in 2013. However, these guidelines present limitations as while reporting require items of specific specialties following the checklist. Authors from different specialities have developed CARE extensions specifying the characteristic features of corresponding fields, however, an extension dealing with physiotherapy assessment and line of management in the CARE guidelines is proposed as PhyCaRe. Method: After consulting with the advisors, a draft will be prepared of the specific elements that should be included in the PhyCaRe using web Delphi methodology considering CARE statement as the source and SurveyMonkey will be used to undertake the web Delphi questionnaire. The web Delphi methodology will be assumed for three rounds and will be open to physiotherapists and others with substantial experience in reviewing case reports. Subsequently, an online consensus meeting, pilot testing, and submission of the CARE extension for physiotherapy will be conducted for publication. Dissemination: The 2010 "Guidance for Developers of Health Research Reporting" and instructions from the EQUATOR Network will be followed in the preparation of PhyCaRe guidelines. The guidelines will be propagated at different platforms and journals will be requested to adopt the guidelines. Registration: The reporting guideline under development is prospectively registered on the EQUATOR Network website on PhyCaRe - Reporting guideline for physiotherapy case reports.