Bilateral Wilms' tumor in childhood: a case report.

Abstract

Introduction: Wilms tumor, also known as nephroblastoma, is the second most common intra-abdominal cancer in childhood and the fifth most frequent pediatric malignancy; it accounts for 6% of all pediatric cancers and is the most common renal tumor (comprising over 95% of all pediatric renal tumors). It typically presents between the ages of 2 and 5, with 95% of cases diagnosed before age 10. The initial presentation is usually an abdominal mass—often detected at an advanced stage of the disease—accompanied by intermittent hematuria. Bilateral renal tumors are very rare in the pediatric population. Diagnosis is achieved via ultrasound, abdominal CT, or MRI; while the diagnosis is based on clinical and imaging findings, definitive diagnosis is histopathological.

Case Report: This case involves a newborn with bilateral Wilms tumor (nephroblastoma), an uncommon presentation among pediatric renal neoplasms. Following physical examination and complementary clinical and imaging studies, a treatment plan focused on nephron-sparing surgery was established. Through a therapeutic intervention combining nephrectomy and nephron-sparing surgery, adequate renal function was maintained in the patient.

Conclusion: Bilateral Wilms tumor represents an atypical and complex presentation requiring a specialized multidisciplinary approach (such as the SIOP UMBRELLA 2016 protocol, chemotherapy, conservative surgical techniques or nephrectomy, and potentially radiotherapy). Implementing nephron-sparing surgery in these cases is crucial for preserving long-term renal function, with histopathological analysis, staging, and comprehensive follow-up during the first year serving as key factors in determining the patient's prognosis.