eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2025-11-02 13 10 59 62 10.12691/ajmcr-13-10-1 AJMCR202513101 article Salma Alhajj Qasem sbustame@najah.edu 1 Adil A. A. Alsweis 1 Samer Bustame 2 Amna Akkawi 3 Department of Medicine, An-Najah National University, PO Box 7, Nablus, West Bank, Palestine Pediatric Surgery, An-Najah National University Hospital, Nablus, West Bank, Palestine An-Najah National University Hospital, Asira Street, Nablus, West Bank, Palestine 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-¡ªhistopathological 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. https://pubs.sciepub.com/ajmcr/13/10/1/ajmcr-13-10-1.pdf Wilms¡¯ tumor Nephron-sparing surgery (NSS) Pediatric nephrectomy