Wilms tumor, also known as nephroblastoma, is the most common renal cancer in infants and young children. Typical treatment combines surgery, chemotherapy, and sometimes radiotherapy. Prognosis is generally favorable when the disease is detected and treated early. We report a typical case of Wilms tumor in a 12-month-old infant and discuss the specific aspects of management in this case. Our patient underwent abdominal ultrasound (instead of MRI due to limited resources) and CT scan, which revealed a large lower-pole left renal mass suggestive of nephroblastoma. She subsequently received neoadjuvant chemotherapy according to the GFA/nephro 2005 protocol, followed by nephrectomy with removal of lombo-aortic and mesenteric lymph nodes. Histopathology confirmed a blastemal-type Wilms tumor, high-risk, stage II (SIOP 2001 classification), with intra-abdominal rupture. Radiotherapy was indicated due to high-risk stage and rupture, with a total dose of 12.5 Gy in 10 fractions.
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