Stage 4 Wilms tumor associated with unusual complications – case report

Written by Papp Zsuzsanna Erzsébet, Horváth Adrienne

Wilms tumor is the most frecvent renal tumor in children with an incidence of 6% of all cancer types (8 cases/1 million children below 14 years). The multidisciplinary approach between oncologist, surgent, pathologist and radioterapeut made a 80–90% surviving rate posible. The 4.5 year old patient was admitted for pallor, fatigability, acute respiratory infections, intense abdominal pain with a great abdominal mass and weight loss about 3 kg in only 4 weeks. The laboratory findings showeded leukocytosis, anemia. The ultrasound describes the 12x70x80 cm right renal mass and the toraco-abdominal CT confirmes it with a right pulmonary metastasis. We started the SIOP Nephroblastoma 2001 neo-adjuvant preoperatory chemotherapy, but only after the first dose he presents massive rectal bleeding, the origin of the blood couldn’t be determinated by the surgeon. After this incident we continued the therapy, the patient is loosing permanently weight, with constantly high inflamattory markers, but after all we finished the preoperatory treatment and we sent him to Budapest for surgery and radiotherapy. The operation solved the enigma of the massive rectal bleeding and the permanent weight loss. Now the 4.5 years old patient is on postoperative chemotherapy associated with local radiotherapy.


Keywords: Wilms tumor, nephroblastoma, child.

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