Wilms tumor in adults. Case report and literature review
Víctor H. Olivares-Villalpando, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
José G. Peñaloza-González, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Martha M. Velázquez-Aviña, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Alan M. García-García, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Alejandra M. Roa-León, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Carlos A. Serrano-Bello, Servicio de Anatomía Patológica, Hospital Juárez de México, Mexico City, Mexico
Yoanna A. Naranjo-Rendón, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Isis Y. Moreno-Yllescas, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Edmundo De-Sandoval-Martínez, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Carmen M.L. García-Ocegueda, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Fernando Traslaviña-Palacios, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Zairid Herrera-Castillero, Servicio de Onco Hemato Pediatría, Hospital Juárez de México, Mexico City, Mexico
Wilms tumor is an extremely rare malignant neoplasm in adults, with approximately 300 cases described in this age group. Clinical outcomes are not as favorable as in children, although with the latest treatment protocols; long-term survival rates of approximately 82% have been reported. A 20-year-old woman presented with abdominopelvic pain, a palpable mass in her left flank, and pain in her right hip bone. A computed tomography scan revealed a tumor originating from the left kidney, metastases to the neck, lungs, liver, retroperitoneum, right acetabulum, and L1 vertebral body, and lymphadenopathy in the mediastinum, pulmonary hilum, and retroperitoneum. She underwent nephrectomy; the pathology report described a Wilms tumor with triphasic histology and diffuse anaplasia. She received treatment according to the UMBRELLA SIOP – Renal Tumor Study Group2016 protocol, regimen for tumors with anaplastic histology in the adult Wilms tumor treatment arm and initial nephrectomy. Disease progression occurred at week 16 of the protocol. The protocol was changed to vincristine-irinotecan and intermediate radiotherapy. The disease was stable after 5 weeks of treatment; however, she died from septic shock. Further clinical trials in adults with Wilms tumor are needed to define effective treatment guidelines.
Keywords: Wilms tumor. Nephroblastoma. Kidney tumors. Renal cancer. Adult nephroblastoma. Cancer.
