article · Clinical Case Reports
Wilms tumour is a malignant embryonal kidney cancer commonly found in children, but it very rarely affects adults. This report describes a rare case involving a 28-year-old female presenting with right flank pain and a palpable mass. Abdominal imaging identified a right renal tumour complicated by tumour thrombi in both the renal vein and the inferior vena cava, alongside bilateral congenital renal abnormalities comprising a partial duplex collecting system on the affected side and a complete duplex system on the other. The patient underwent a successful right radical nephrectomy combined with complete tumour removal from the inferior vena cava via venacavotomy. Histopathology and immunohistochemistry confirmed a triphasic nephroblastoma, and the patient subsequently started adjuvant chemotherapy. The case highlights potential shared developmental pathways between Wilms tumour and duplex collecting systems.
Kidney cancers in adults are typically renal cell carcinomas, making unexpected diagnoses like adult Wilms tumour challenging to identify and manage. Documenting complex surgical treatments for rare tumours with major vascular involvement helps clinical teams establish reliable diagnostic pathways and effective multidisciplinary treatment strategies for unusual oncology presentations.
The abstract does not indicate an application pathway, as it reports a single clinical case and highlights the need for fundamental research into shared pathogenesis rather than presenting a commercial product or service.
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Wilms' tumor (WT), also known as nephroblastoma, is a malignant embryonal kidney tumor composed of embryonic cells and is the most prevalent tumor among children, but isolated cases occur infrequently in the adult population. Adult WT is defined according to the criteria of Kilton, Matthews, and Cohen, which comprise age above 15 years and histological patterns characteristic of WT. We report a case of an adult WT with venous thrombus on an incomplete duplex collecting system. To the best of our knowledge, this is the first case of adult WT with such a presentation. A 28-year-old female patient presented to our department with a 4-month history of right flank pain and flank mass and was diagnosed by abdominal contrasted CT to have a right renal tumor with tumor thrombi in the renal vein and the inferior vena cava. The CT scan also revealed a bilateral duplex collecting system with a partial (ureter fissus proximalis) on the tumor side and a complete duplex system on the contralateral side. Right radical nephrectomy with complete tumor thrombectomy via venacavotomy was performed successfully. Histopathological examination of the specimen revealed a triphasic nephroblastoma with immunohistochemistry confirmation. Postoperatively, adjuvant chemotherapy was initiated. The increasing incidence of non-syndromic WT cases associated with duplex collecting systems suggests a potential shared pathogenesis, necessitating further research.
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DOI: 10.1002/ccr3.70136
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