Tagoe Lily G, Bonney Nana Yaa A, Amoako Emmanuella, Amegan-Aho Kokou H, Gbadamosi Hafisatu, Dadzie Mary-Ann, Segbefia Catherine I
Child Health, Korle Bu Teaching Hospital, Accra, GHA.
Pediatrics and Child Health, University of Health and Allied Sciences, Ho, GHA.
Cureus. 2024 Feb 21;16(2):e54640. doi: 10.7759/cureus.54640. eCollection 2024 Feb.
Wilms tumor (WT) is the most common renal malignancy of childhood. The common metastatic sites are the lungs, liver, and lymph nodes, with brain and bone metastases occurring rarely. Metastatic disease can be present at initial diagnosis or may occur with relapse or disease progression. The majority of relapses in WT occur within the first two years post-treatment. Late relapses are rare. This article describes four cases of WT, each demonstrating an unusual site or timing of metastases. Case 1 presented primarily with jaw metastases, Case 2 presented with bone (vertebrae) and spinal metastases manifesting as paraplegia, at relapse one year after completion of treatment, Case 3 presented with isolated liver metastases four years after treatment completion, and Case 4 presented with brain metastases after six weeks of treatment abandonment. This case series demonstrates the varied pattern of metastases of WT and highlights the need for a high index of suspicion for WT among patients who present with unusual sites of tumor or for metastasis in those who present with neurologic symptoms during or after treatment.
肾母细胞瘤（WT）是儿童期最常见的肾脏恶性肿瘤。常见的转移部位是肺、肝和淋巴结，脑和骨转移很少见。转移性疾病可在初诊时出现，也可能在复发或疾病进展时发生。WT的大多数复发发生在治疗后的头两年内。晚期复发很少见。本文描述了4例WT病例，每例均表现出不寻常的转移部位或转移时间。病例1主要表现为颌骨转移，病例2在治疗完成一年后复发时出现骨（椎骨）和脊髓转移，表现为截瘫，病例3在治疗完成四年后出现孤立的肝转移，病例4在放弃治疗六周后出现脑转移。该病例系列展示了WT转移的多样模式，并强调对于出现不寻常肿瘤部位的患者或在治疗期间或治疗后出现神经症状的转移患者，需要高度怀疑WT。
