Bilateral Wilms’ Tumor: Challenges in Pediatric Nephron-Sparing Strategies and Multimodal Management

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

¹Department of Medicine, An-Najah National University, PO Box 7, Nablus, West Bank, Palestine

²Pediatric Surgery, An-Najah National University Hospital, Nablus, West Bank, Palestine

³An-Najah National University Hospital, Asira Street, Nablus, West Bank, Palestine

Cite this paper:
Salma Alhajj Qasem, Adil A. A. Alsweis, Samer Bustame and Amna Akkawi. Bilateral Wilms’ Tumor: Challenges in Pediatric Nephron-Sparing Strategies and Multimodal Management. American Journal of Medical Case Reports. 2025; 13(10):59-62. doi: 10.12691/ajmcr-13-10-1

Abstract

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.

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

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