Wilms' Tumor in Horseshoe Kidney

Association of Wilms Tumor with Crossed Fused Renal Ectopia in Children: A Case Report

Introduction

Wilms tumor is the most common renal malignancy in children. The occurrence of Wilms tumor with various congenital genitourinary anomalies has been reported, particularly in horseshoe kidneys, hypospadias, disorder of sexual development, and double collecting system. However, Wilms tumor with crossed renal ectopia is a rare finding.

Case Description

We are reporting a case report of Wilms tumor in a 3-year-old girl who presented with a huge left flank mass with cross-fused renal ectopia. After the initial workup and triphasic computed tomography scan of the chest, abdomen, and pelvis for confirmation of diagnosis and metastasis, the patient underwent image-guided tissue biopsy, followed by neoadjuvant chemotherapy, left radical nephrectomy with separation of fused right ectopic renal moiety, and adjuvant chemoradiation.

Practical Implication

This report shows an association of Wilms tumor with cross-fused renal ectopia, a rare combination. Unusual findings on imaging with unilateral flank mass should be considered as part of the differential diagnosis for this rare finding. Adjuvant chemotherapy and modern imaging helped delineate the anatomy and ease the surgery for safe resection, improving the overall outcome.

Wilms tumor in horseshoe kidney with extensive vascular thrombosis: A case report

INTRODUCTION AND IMPORTANCE

Wilms tumor (WT), a prevalent pediatric renal malignancy (7 %), frequently intertwines with genitourinary anomalies. This unique report presents a case of WT combined with horseshoe Kidney and an extending atrial thrombus, emphasizing critical management considerations.

CASE PRESENTATION

A 3-year-old boy, experiencing flank pain and weight loss, manifested a WT linked to horseshoe Kidney, accompanied by an atrial thrombus. Neoadjuvant chemotherapy downsized the tumor and thrombus, enabling successful surgical intervention. Post-surgery, 27 weeks of adjuvant chemotherapy were administered. Over three years, follow-up exhibited renal recovery, no recurrence, and clear CT scans.

DISCUSSION

Prompt identification, precise imaging (via CT angiography), and multidisciplinary care are pivotal for managing WT in horseshoe Kidney cases. Preoperative chemotherapy notably reduced tumor and thrombus sizes, enhancing surgical feasibility. Long-term vigilance is essential for recurrence and treatment-related complications.

CONCLUSION

Effectively managing WT in horseshoe Kidneys demands timely recognition, meticulous imaging, and collaborative management. Successful outcomes highlight preoperative chemotherapy's benefits and underscore extended monitoring's significance in confirming sustained recovery.