Adolescent Renal Tumours: Diagnostic and Therapeutic Challenges in a Transitional Age Group-A Multidisciplinary Case...

The management of renal neoplasms in adolescent patients poses unique clinical challenges due to their transitional position between paediatric and adult populations. This age group exhibits marked heterogeneity in tumour histology, ranging from entities commonly observed in paediatric oncology to tumours typical of adult age, as well as rare histological subtypes that exceptionally affect the kidney. Given the substantial differences in clinical protocols between paediatric and adult populations, rigorous multidisciplinary evaluation is essential to determine optimal diagnostic and therapeutic strategies for adolescent patients.

We present four cases from our tertiary referral centre that illustrate the variability in radiological and histopathological presentations and clinical outcomes in this population, underscoring the critical importance of a multidisciplinary approach. Case 1 demonstrates the typical management of Wilms' tumour in an older paediatric patient. Case 2 exemplifies the diagnostic challenge of distinguishing between Wilms' tumour and renal cell carcinoma at the upper end of the adolescent spectrum. Case 3 revealed the unexpected diagnosis of renal Ewing sarcoma in a 13-year-old female. Case 4 highlights the potential for severe perioperative complications, including life-threatening thromboembolic events, in a patient with Wilms' tumour.

The variability in tumour types, biological behaviour, and potential for severe complications underscores the necessity of comprehensive multidisciplinary management in specialized hospital settings. An integrated approach ensures accurate diagnosis, individualized treatment planning, and effective management of complications, ultimately optimizing outcomes for adolescent patients with renal neoplasms.