Bilateral Wilms tumors (nephroblastoma)

Case contributed by Dr Chris O'Donnell

Presentation

Parent palpated a mass in the left side of the abdomen. O/E large firm left-sided mass

Patient Data

Age: 4
Gender: Female

Soft tissue density masses on either side of the abdomen causing extrinsic compression to the bowel.  No calcification.

Ultrasound

Solid mass lesions arising from both kidneys (left larger than right) with abnormal blood flow on color Doppler.  No definite renal vein invasion.

Case Discussion

Synchronous bilateral Wilms tumor is rare (5 - 10% of cases) but well recognized, conferring a worse prognosis as surgical excision is much more difficult.  Emphasis is now on neoadjuvant chemotherapy followed by surgery for residual masses.  As far as staging goes, it is described as stage V irrespective of local staging of each tumor mass.  Presentation is typically delayed as children are asymptomatic.  Parental palpation of a mass is the usual scenario.

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Case information

rID: 50560
Published: 15th Jan 2017
Last edited: 16th Jul 2018
System: Urogenital
Inclusion in quiz mode: Included

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