Adult Wilms’ Tumor: a case report with review of literature
Department of Urology, College medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
Wilms’ tumor (nephroblastoma, WT) is thought to derive from primitive metanephric blastema, the precursor of normal kidney. WT is the most common primary malignant renal tumor in children. Conversely, it occurs rarely in adults. This present report describes a rapid-growing right renal tumor in a 48-year-old woman with the initial presentation of palpable right flank mass. A contrast-enhanced computed tomography (CT) scan confirmed the presence of one huge right renal mass about 11cm (the estimated volume, 670 mm3). This woman refused to undergo operation initially. Five months later, the tumor rapidly grew up to 16 cm (the estimated volume, 1610 mm3). Also, chest CT scan revealed multiple lung nodules and lung metastases is impressed. The patient received right radical nephrectomy and the pathology demonstrated Wilms’ tumor. However, the patient refused subsequent systemic chemotherapy.
Due to the rarity of adult Wilms’ tumor, no standard treatment have been established to date. Adult Wilms’ tumor is treated according to recent pediatric protocols. Herein we also reviewed the literature in terms of diagnosis, treatment strategy and prognosis.