Salma Alhajj Qasem^1,, Adil A. A. Alsweis¹, Samer Bustame², Amna Akkawi³

Abstract Wilms' tumor, or nephroblastoma, is a rare pediatric kidney cancer that poses significant challenges, particularly in bilateral cases where preserving kidney function is critical. A 3-year-old girl presented with tumors in both kidneys, detected via ultrasonography and further evaluated with computed tomography (CT), revealing masses measuring 9.5 × 10 × 11 cm in the right kidney and 10 × 11 × 13.5 cm in the left. After ten weeks of chemotherapy with vincristine, dactinomycin, and doxorubicin, she underwent laparoscopic partial nephrectomy of the left kidney and excision of three tumors from the right-—histopathological analysis confirmed stage 5 intermediate-risk Wilms' tumor. Postoperatively, systemic adjuvant chemotherapy was administered, and routine follow-up evaluations confirmed no tumor recurrence and stable kidney function. This case underscores the complexity of treating bilateral Wilms' tumor and highlights the need for a delicate balance between aggressive oncologic treatment and the preservation of essential organ function.

Wilms’ tumor, Nephron-sparing surgery (NSS), Pediatric nephrectomy