Qari Wadah, Alzahrani Alyazid, Alzahrani Mohammed, Saleh Yasir, Almasabi Abdulrahim, Bawazir Osama
General Surgery, Umm Al-Qura University, Makkah, SAU.
Medicine, Umm Al-Qura University, Makkah, SAU.
Cureus. 2022 Oct 22;14(10):e30593. doi: 10.7759/cureus.30593. eCollection 2022 Oct.
Wilms' tumor (WT) is a common type of primary renal tumor in the pediatric population that can equally affect both sides. Herein, we describe a case of bilateral Wilms' tumor (BWT) in a three-year-old male with different responses to preoperative chemotherapy in the two kidneys. The left kidney mass responded poorly to chemotherapy than the right kidney, which raised the suspicion of coexisting benign disease or congenital anomaly. However, it was ruled out by preoperative nuclear scan and ultrasound-guided frozen section biopsy taken from the left kidney mass. The report of a frozen section on hematoxylin and eosin (H&E) stain was positive for the small blue cell tumor. The patient was managed successfully with a total nephrectomy of the right kidney and nephron-sparing surgery (NSS) on the left kidney. The postoperative period was uneventful and was managed successfully with radiotherapy. Despite many challenges faced in the management of bilateral Wilms' tumor, surgery is the most preferable mode of therapy with chemotherapy and radiotherapy being effective in certain cases. The patient was followed up till no signs of recurrence or metastasis were observed.
肾母细胞瘤（WT）是儿科人群中常见的原发性肾肿瘤类型，双侧均可发病。在此，我们描述一例3岁男性双侧肾母细胞瘤（BWT）病例，其双肾对术前化疗的反应不同。左肾肿块对化疗的反应比右肾差，这引发了对并存良性疾病或先天性异常的怀疑。然而，术前核扫描和从左肾肿块获取的超声引导下冰冻切片活检排除了这种怀疑。苏木精和伊红（H&E）染色的冰冻切片报告显示小蓝细胞肿瘤呈阳性。该患者通过右肾全肾切除术和左肾保肾手术（NSS）成功治疗。术后过程顺利，并通过放疗成功处理。尽管在双侧肾母细胞瘤的治疗中面临诸多挑战，但手术仍是最优选的治疗方式，化疗和放疗在某些情况下也有效。对该患者进行随访，直至未观察到复发或转移迹象。
