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Relapsed Wilms' tumor with multiple brain metastasis.

Akın Akakın¹, Baran Yılmaz¹, Murat Şakir Ekşi²

¹Department of Neurosurgery, Bahçeşehir University Medical Faculty, Istanbul, Turkey.

Korean Journal of Pediatrics

|December 27, 2016

Summary

Brain metastasis from childhood Wilms tumor is rare. This case highlights the importance of cranial surveillance and aggressive multimodal therapy for improved outcomes in pediatric oncology.

Keywords:

Chemotherapy Metastasis Radiotherapy Surgery Wilms tumor

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Area of Science:

Pediatric Oncology
Neuro-oncology
Pediatric Nephrology

Background:

Wilms tumor is the predominant malignant renal neoplasm in children.
Anaplastic histopathology in Wilms tumor is associated with aggressive disease.
Metastasis to the brain from Wilms tumor is an uncommon event.

Purpose of the Study:

To report a rare case of anaplastic Wilms tumor with extensive brain metastases.
To emphasize the diagnostic challenges and therapeutic considerations for CNS involvement in Wilms tumor.
To advocate for routine cranial surveillance in high-risk pediatric renal tumors.

Main Methods:

Case presentation of an 8-year-old female diagnosed with Wilms tumor.
Detailed description of clinical presentation, diagnostic work-up, and treatment course.
Review of literature regarding brain metastases in pediatric Wilms tumor.

Main Results:

The patient developed multiple brain metastases 5 years post-initial diagnosis.
Cerebellar mass resection and whole-brain radiotherapy were performed.
Despite aggressive treatment, the patient's outcome was poor, succumbing to the disease.

Conclusions:

Clinical suspicion of neurological compromise warrants cranial surveillance in Wilms tumor patients.
Aggressive combined therapy (surgery, radiotherapy, chemotherapy) is crucial for managing brain metastases.
Early detection and intervention are vital for potentially improving survival and palliative care in pediatric brain metastases from Wilms tumor.