Wilms’ Tumor in Horseshoe Kidney and Solitary Kidney

Abstract

AbstractWilms’ tumor in horseshoe kidney (HSK) and solitary kidney is an uncommon occurrence, and their management poses a daunting surgical challenge. Imaging aids in diagnosis and delineating the anatomy and blood supply making resection safe and reducing complications. Neoadjuvant chemotherapy downstages the tumor and reduces the incidence of spill, thereby making inoperable tumors amenable to resection and reduces chances of recurrence. Pre-operative chemotherapy is recommended in Wilms’ tumor in solitary kidney before nephron sparing surgery (NSS).Learning objectives of this chapter are to understand the presentation, origin, the role of imaging and neo-adjuvant chemotherapy, surgical principles, and outcome in Wilms’ tumor in HSK and solitary kidney. Special emphasis is on imaging detailing the varied anatomical variations in the blood supply of HSK which helps the surgeon in planning resection. The role of pre-operative chemotherapy followed by NSS in Wilms’ tumor in solitary kidney and subsequent development of end stage renal disease (ESRD) in some patients is also highlighted.KeywordsWilms’ tumorHorseshoe kidney (HSK)Solitary kidneyNephron sparing surgery (NSS)End stage renal disease (ESRD)