General and Digestive Surgery Department, Hospital Universitario HM Sanchinarro, Madrid, Madrid, Spain.
General and Digestive Surgery Department, Hospital Universitario HM Sanchinarro, Madrid, Madrid, Spain
BMJ Case Rep. 2023 Nov 15;16(11):e256270. doi: 10.1136/bcr-2023-256270.
Late relapses of Wilms tumour are extremely uncommon but still represent possible events. Even more rarely Wilms tumours present as extrarenal neoplasms, for which it could be difficult to diagnose and treat them promptly.We present a unique case of late recurrence of Wilms tumour 16 years after the primary diagnosis, with location in the gynaecological system. The relapse presented as a vaginal mass, and it gradually raised up to involve the majority of pelvic organs. We accurately studied the tumour extension, even realising a 3D preoperative reconstruction, and we managed to evaluate the patient with a multidisciplinary team involving general surgeons, urologists, gynaecologists and plastic surgeons. We finally decided for an extended surgical approach and realised a complete pelvic exenteration. Three months after surgery, the patient is in a good general condition, without major surgical complications and with no radiological signs of pelvic tumour relapse.
Wilms 瘤的晚期复发极为罕见,但仍有可能发生。更为罕见的是,Wilms 瘤表现为肾外肿瘤,这可能难以及时诊断和治疗。我们报告了一例罕见的 Wilms 瘤 16 年后在妇科系统中的晚期复发的独特病例。复发表现为阴道肿块,逐渐增大并累及大部分盆腔器官。我们准确地研究了肿瘤的扩展情况,甚至实现了 3D 术前重建,并通过多学科团队(包括普外科医生、泌尿科医生、妇科医生和整形外科医生)对患者进行了评估。我们最终决定采用广泛的手术方法,并完成了完全的盆腔廓清术。术后 3 个月,患者一般状况良好,无重大手术并发症,盆腔肿瘤无复发的影像学征象。