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Summary
A rare case of Wilms tumor presented as gross hematuria and a renal pelvic mass in a 15-month-old boy. Radical nephrectomy is recommended for Wilms tumor extending into the collecting system.
Area of Science:
- Pediatric Oncology
- Urologic Pathology
Background:
- Wilms tumor, a common pediatric kidney cancer, typically presents differently.
- Gross hematuria and a large polypoid renal pelvic mass are rare initial signs.
Observation:
- A 15-month-old boy presented with gross hematuria and a large, polypoid mass in the renal pelvis.
- Surgical exploration revealed a Wilms tumor with limited parenchymal invasion and rupture into the collecting system.
Findings:
- The case highlights a rare presentation of nephroblastoma (Wilms tumor).
- Differentiation from other rare pediatric renal pelvic lesions is crucial.
- Radical nephrectomy with total ureterectomy is advised for Wilms tumor invading the collecting system.
Implications:
- Preoperative cystoscopy and retrograde pyelography are essential for diagnosing renal tumors with gross hematuria.
- Surgical approach (radical vs. conservative) must be carefully considered for rare renal pelvic lesions.
- Early and accurate diagnosis is vital for effective treatment of pediatric renal tumors.