Literature Review of an Adult Woman with Wilms' Tumor

Abstract

Wilms' tumor (WT), also known as nephroblastoma, is considered as an embryonal tumor due to nephrogenesis and histologic mimics of the early-onset age. WT is the most common renal tumor in children, but it is extremely rare in adults. WT is known to be a very chemosensitive tumor, and modern clinical trials aim to improve risk classification to reduce the burden of treatment. Diagnosis of WT is usually made after nephrectomy, so the possibility of preoperative chemotherapy is only possible in patients diagnosed with biopsy. A 48-year-old female with a history of 3-week left upper quadrant and left flank pain applied to a general practitioner. There was no previous trauma, hematuria, or other systemic symptoms. Further investigation with computed tomography (CT) scan of the abdomen with intravenous contrast revealed enlarged left kidney mass lesion within the left lower pole measuring up to 7.4 cm × 7.5 cm × 9.2 cm [Figure 1]. The patient underwent open radical left nephrectomy, retroperitoneal lymph node dissection, and partial excision [Figure 2]. Radical nephrectomy was performed, and when nephroblastoma was detected in histopathological examination, she was consulted with medical oncology. After positron emission tomography-CT examination revealed a thyroid involvement, a biopsy was performed, and it was diagnosed as papillary thyroid carcinoma. Total thyroidectomy was performed by the ear, nose, and throat and papillary thyroid carcinoma was diagnosed. Then, the patient started on vincristine dactinomycin therapy. There was no recurrence at the 3rd, 6th, 12th, and 36th month controls of the patient.