A rare case of fetal bilateral Wilms' tumor in horseshoe kidney: A case report.

INTRODUCTION AND IMPORTANCE

Wilms' tumor is the most common malignant kidney tumor in children. The horseshoe kidney is the most common renal fusion malformation. However, Wilms' tumor is rarely identified in horseshoe kidney patients. The incidence of horseshoe kidney is about 1 in 400 cases. Wilms' tumor or Nephrogenic rests can occur in both kidneys, termed bilateral disease, found in only 5-8 % of cases. Management of bilateral Wilms' tumor presents a major clinical challenge in terms of maximizing survival, preserving renal function, and understanding underlying genetic risk.

CASE PRESENTATION

Our case is a 28-year-old primigravid female patient, who came for the complaint of decreased abdominal girth and decreased fetal moment. Obstetric ultrasound concluded severe oligohydramnios + renal mass and safe termination was done. Subsequent examinations of the autopsy revealed bilateral Wilms tumor in horseshoe kidney.

CLINICAL DISCUSSION

Ultrasound is used to diagnose horseshoe kidneys, whereas Computed tomography and magnetic resonance imaging are often used for staging purposes. Histopathological analysis is the current gold standard for diagnosing Wilms' tumor. Surgery, chemotherapy, and radiotherapy are also used to treat Wilms' tumor.

CONCLUSION

Fetal Wilms' tumor (WT) is extremely rare, but advances in fetal imaging have led to increased detection of such cases. Managing these cases remains challenging due to the complexity of treatment and the needed for preserving renal function. Prenatal ultrasound is an essential diagnostic tool for early detection and intervention.