Antenatally diagnosed wilms' tumour

Area of Science:

• Pediatric Oncology
• Neonatal Surgery
• Fetal Medicine

Background:

• Wilms' tumour (WT) is a rare embryonic kidney cancer, seldom diagnosed prenatally, especially in neonates.
• Hydrops foetalis, a severe condition of fluid accumulation in a fetus, can present with complex medical challenges.
• Prenatal diagnosis of fetal anomalies is crucial for timely intervention and improved outcomes.

Observation:

• A case of a female neonate with antenatally diagnosed left-sided Wilms' tumour complicated by hydrops foetalis is presented.
• The fetus experienced distress, necessitating an emergency lower segment caesarean section (LSCS) at 34 weeks gestation.
• The neonate required mechanical ventilation due to birth asphyxia and suffered from congestive cardiac failure.

Findings:

• Postnatal stabilization allowed for gross total resection of the Wilms' tumour on the fourth day of life.
• Histopathological examination confirmed classical Wilms' tumour, stage I.
• Despite intensive supportive care and surgical management, the infant passed away on the second postoperative day.

Implications:

• This case underscores the rarity and challenges associated with prenatal diagnosis and management of neonatal Wilms' tumour.
• The co-occurrence of hydrops foetalis presents significant medical complexities, impacting neonatal survival.
• Further research into early detection and multimodal treatment strategies for fetal Wilms' tumour is warranted.