Synchronous bilateral Wilms' tumor with liver metastasis

Area of Science:

• Pediatric Oncology
• Nephrology

Background:

• Wilms tumor (nephroblastoma) typically presents unilaterally, with bilateral cases occurring in 5-8% of patients.
• Synchronous or metachronous bilateral Wilms tumors are uncommon, and liver metastasis is particularly rare.

Observation:

• An 8-year-old male presented with abdominal swelling and flank pain, revealing multiple renal lesions and a large liver mass on imaging.
• Renal biopsy indicated a favorable response to chemotherapy, but nephron-sparing surgery was not feasible.

Findings:

• The patient received conservative management with palliative chemotherapy (adriamycin and vincristine).
• Metastatic bilateral Wilms tumor is associated with a poor prognosis, lacking established evidence-based treatment guidelines.

Implications:

• This case highlights the challenges in managing rare metastatic Wilms tumor presentations.
• Early integration of palliative care and symptom management significantly benefited the patient.