Abstract
BackgroundWilms’ tumor (nephroblastoma) is mostly unilateral; however, bilateral Wilms’ tumors are seen in about 5–8% of patients. This can be synchronous or metachronous. It is uncommon to get liver metastasis from bilateral Wilms’ tumor.Case presentationAn 8-year-old male Ugandan presented with a history of abdominal swelling and flank pains for 1 year. There was no history of hematuria. Both ultrasound and computed tomography of the abdomen demonstrated multiple solid lesions in both kidneys and a huge solid mass in segments V, VI, VII and VIII of the liver. Histological examination of renal biopsy specimen was favorable for chemotherapeutic regimens. However, following a multidisciplinary tumor board consensus, a nephron-sparing surgery was deemed unsuitable, and he was managed conservatively with chemotherapy (adriamycin and vincristine) with a palliative intent.ConclusionsMetastatic bilateral Wilms’ tumor has a particularly poor prognosis. There are no clear evidence-based guidelines for the management of this rare presentation. This patient benefited from early palliative care and symptom management.
Highlights
Wilms’ tumor is mostly unilateral; bilateral Wilms’ tumors are seen in about 5–8% of patients
It is uncertain whether bilateral nephronsparing surgery improves prognosis of patients [6]
Case presentation An 8-year-old male Ugandan child presented with a 1-year history of a progressive abdominal swelling and flank pains
Summary
Metastatic bilateral Wilms’ tumor has a poor prognosis. There are no clear evidence-based guidelines for the management of this rare presentation.
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