戴大堯、蔡育賢

國立成功大學附設醫院 泌尿部

Ta-Yao Tai, Yuh-Shyan Tsai

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.