Nephroureterectomy for Pediatric Giant Wilms Tumor

Pigur Agus Marwanto, Ibnu Sina Ibrahim

Abstract


Introduction: Wilms' tumor most often occurs in children, with an average age of about 3 to 4 years. About 75% of cases occur in young children aged less than 5 years. These tumors usually develop in one kidney. In the United States, surgery is the first treatment for most Wilms tumors, followed by chemotherapy. According to the International Society of Pediatric Oncology, neoadjuvant chemotherapy is performed first, followed by surgery. Case Presentation: Two Years and six months child was referred to our hospital with giant abdominal mass with difficulty to determine its origin due to its large size. On examination, it was found that the abdomen was distended with a mass palpable in all of quadrant of abdomen. A contrast enhanced abdominal CT showed a solid lumpy mass in the left kidney with a size of 22.36 x 19.66 x 17.12 cm. The renal mass crossed the midline and filled most of the abdominal cavity. The contra lateral kidney shows normal function. Discussion: The most patient come with presenting complaint was abdominal mass (50%), and 35% of the patients presented with an abdominal lump. Western studies reported 74% of patients presenting with an abdominal mass. A study by Guruprasad et al reported that 90% of their patients presented with abdominal mass. Conclusion: Combination of Neoadjuvant chemotherapy and Surgery is important in the management of Wilms Tumor. Radical Nephrectomy and Ureterectomy can be performed safely if performed by an experienced surgeon

 


Keywords


Wilms' tumor, Neoadjuvant chemotherapy, Radical Nephrectomy

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References


Szychot E, Apps J, Pritchard-Jones K. Wilms' tumor: biology, diagnosis and treatment. Transl Pediatr. 2014 Jan;3(1):12-24. doi: 10.3978/j.issn.2224-4336.2014.01.09

. Bhutani N, Kajal P, Sharma U. Many faces of Wilms Tumor: Recent advances and future directions. Ann Med Surg (Lond). 2021 Mar 7;64:102202.doi:10.1016/j.amsu.2021.102202.

. PDQ Pediatric Treatment Editorial Board. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®): Health Professional Version. 2024 Jan 4.

. Leung, R. S., Liesner, R., & Brock, P. (2004). Coagulopathy as a presenting feature of Wilms tumour. European journal of pediatrics, 163(7), 369–373. https://doi.org/10.1007/s00431-004-1443-8

. Israels, T., Moreira, C., Scanlan, T., Molyneux, L., Kampondeni, S., Hesseling, P., Heij, H., Borgstein, E., Vujanic, G., Pritchard-Jones, K., & Hadley, L. (2013). SIOP PODC: clinical guidelines for the management of children with Wilms tumour in a low income setting. Pediatric blood & cancer, 60(1), 5–11. https://doi.org/10.1002/pbc.24321

. Singh P, Singh D, Kumar B, et al. Profile and Clinical Outcome of Children with Wilms’ Tumor treated at a Tertiary Care Centre, India. South Asian J Cancer 2022;11 (3):260–268

. Xie W, Wei L, Guo J, Guo H, Song X, Sheng X. Physiological functions of Wilms' tumor 1-associating protein and its role in tumourigenesis. J Cell Biochem. 2019 Jul;120(7):10884-10892

. Wilairat P, Kengkla K, Kaewpanan T, Kaewthong J, Ruankon S, Subthaweesin C, Stenehjem DD, Saokaew S. Comparative efficacy and safety of interventions for preventing chemotherapy-induced oral mucositis in adult cancer patients: a systematic review and network meta-analysis. Eur J Hosp Pharm. 2020 Mar;27(2):103-110.

. Graf, N., Tournade, M. F., & de Kraker, J. (2000). The role of preoperative chemotherapy in the management of Wilms' tumor. The SIOP studies. International Society of Pediatric Oncology. The Urologic clinics of North America, 27(3), 443–454. https://doi.org/10.1016/s0094-0143(05)70092-6

. Rydzewska, L., Tierney, J., Vale, C. L., & Symonds, P. R. (2012). Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. The Cochrane database of systematic reviews, 12(12), CD007406. https://doi.org/10.1002/14651858.CD007406.pub3

. Anastasiou, J., Karatzas, T., Felekouras, E., Tokas, T., Koutalellis, G., Mitropoulos, D., & Constantinides, C. (2012). Radical nephrectomy with transperitoneal subcostal incision for large and locally advanced tumors of the right kidney. Anticancer research, 32(11), 5023–5029.

. Li, P., Tao, J., Deng, X., Qin, C., Cheng, Y., Li, P., Zhang, J., Cao, Y., Yang, X., Yang, C., & Lu, Q. (2017). Extraperitoneal Laparoscopic Radical Nephroureterectomy and Lymph Node Dissection in Modified Supine Position. Urology, 107, 126–131. https://doi.org/10.1016/j.urology.2017.05.048

. Namita Bhutani. Many faces of Wilms Tumor: Recent advances and future directions. ublished online 2021 Mar 7. doi: 10.1016/j.amsu.2021.102202

. Anastasiou, J., Karatzas, T., Felekouras, E., Tokas, T., Koutalellis, G., Mitropoulos, D., & Constantinides, C. (2012). Radical nephrectomy with transperitoneal subcostal incision for large and locally advanced tumors of the right kidney. Anticancer research, 32(11), 5023–5029.

. Bedaiwy MA, Zhang A, Henry D, Falcone T, Soto E. Surgical anatomy of supraumbilical port placement: implications for robotic and advanced laparoscopic surgery. Fertil Steril. 2015 Apr;103(4):e33.

. Blaney, S.M., Kun, L.E. et al . Tumors of the central nervous system. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006: 27: 786-864.




DOI: https://doi.org/10.33854/heme.v7i3.1820

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