Abstract
Nephroblastoma (Wilms tumour) is the most common kidney malignancy in children and one of the most frequent abdominal tumours diagnosed in pediatric patients. We present the case of a 2-year-old boy diagnosed with intermediate-risk, regressive-type nephroblastoma of the left kidney in 2010. He was treated with neoadjuvant chemotherapy followed by surgery and chemotherapy (following the International Society of Pediatric Oncology- SIOP protocol). After 11 months a metastasis was discovered in the left lungand the patient was (re)classified as being high risk and treated with seven cyclesof chemotherapy. After nine disease-free years, the routine follow-up chest CT scan showed a 10/5cm tumor in the left lung involving the pleura. The tumor was completely resected, and pathology confirmed a distal recurrence of nephroblastoma. The patient was further treated according to the UMBRELLA protocol (BB group) with chemotherapy and local irradiation. The tumor bed was irradiated with 25.2 Gy/14 fr, using Helical Tomotherapy. Following radiotherapy, hereceived a high dose chemotherapy and autollogus stem-cell transplant, with a good response and without disease recurrence.
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