Mbwambo Orgeness Jasper, Yusuph Misca, Mwakipunda Leila E, Mbwambo Jasper, Mremi Alex, Ngowi Bartholomeo Nicholaus
Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania; Department of Urology, The KCMC University, Box 2240, Moshi, Tanzania.
Department of Urology, The KCMC University, Box 2240, Moshi, Tanzania.
Int J Surg Case Rep. 2025 Sep;134:111670. doi: 10.1016/j.ijscr.2025.111670. Epub 2025 Jul 11.
The concomitant occurrence of Wilms' tumor (WT) and Renal cell (RCC) carcinoma represents a very rare urological entity. While the majority of Wilms' respond to chemotherapy, RCC is known as a prototype of chemotherapy and radiation-resistant malignancy. The coexistence of these two renal malignancies gives a unique diagnosis and therapy challenges due to resistance to neoadjuvant chemotherapy. Due to the rarity of concomitant occurrence of these two malignancies in the same kidney and challenges associated with management, we report such a rare case we experienced in our hospital.
A seven-year-old boy who attended our hospital with a history of progressive abdominal distension over the past six months. The Computed tomography scan suggested WT with metastasis to the lungs and cervical lymph nodes. However, the tumor was resistant to neoadjuvant chemotherapy and radical nephrectomy was performed and histology results showed concomitant occurrence of WT and RCC.
Concomitant occurrence of WT and RCC poses a challenge in treatment, as while Wilms' tumor is sensitive to chemotherapy, RCC is the prototype of tumors that are chemo-resistant. Therefore, whenever there is no response to neoadjuvant chemotherapy in patients suspected to have WT, a differential diagnosis of concomitant occurrence with RCC should be considered.
A differential diagnosis of concomitant Wilms' tumor and Renal Cell carcinoma should be considered whenever a pediatric tumor presumed to be Wilms' tumor is resistant to standard neoadjuvant chemotherapy for Wilms' tumor.
肾母细胞瘤（WT）与肾细胞癌（RCC）同时发生是一种非常罕见的泌尿系统疾病。虽然大多数肾母细胞瘤对化疗有反应，但肾细胞癌是已知的对化疗和放疗耐药的恶性肿瘤的典型代表。这两种肾脏恶性肿瘤的共存由于对新辅助化疗耐药而带来了独特的诊断和治疗挑战。由于这两种恶性肿瘤在同一肾脏中同时发生的情况罕见以及与之相关的管理挑战，我们报告了我们医院遇到的这样一例罕见病例。
一名7岁男孩因过去6个月进行性腹胀前来我院就诊。计算机断层扫描显示肾母细胞瘤伴肺和颈部淋巴结转移。然而，该肿瘤对新辅助化疗耐药，遂进行了根治性肾切除术，组织学结果显示肾母细胞瘤和肾细胞癌同时存在。
肾母细胞瘤和肾细胞癌同时发生在治疗上构成挑战，因为肾母细胞瘤对化疗敏感，而肾细胞癌是化疗耐药肿瘤的典型代表。因此，每当疑似肾母细胞瘤的患者对新辅助化疗无反应时，应考虑与肾细胞癌同时发生的鉴别诊断。
每当推测为肾母细胞瘤的小儿肿瘤对肾母细胞瘤的标准新辅助化疗耐药时，应考虑肾母细胞瘤和肾细胞癌同时发生的鉴别诊断。
