Renal Parenchyma Preservation in Giant Bilateral Wilms Tumor Following SIOP-Based Multistage Therapy: A Brief Report
Year: 2025
Type: preprint
Study design: Case Report
Abstract: Wilms tumor (WT) is the most common malignant renal tumor in children, with bilateral presentation in 5–7% of cases. These rare tumors require a delicate balance between oncologic safety and renal preservation. We report a 16-month-old boy with giant bilateral WT treated according to the SIOP-2016 protocol. Despite neoadjuvant chemotherapy, no significant tumor reduction occurred. Functional scintigraphy revealed that the right kidney contributed only 1% to total renal function, leading to right nephrectomy. A staged nephron-sparing surgery (NSS) was subsequently performed on the left kidney. Histopathology confirmed biphasic nephroblastoma with predominant mesenchymal component and grade III regression. Six-month follow-up showed compensatory hypertrophy of the preserved kidney with stable renal function, avoiding transplantation. This case highlights the importance of functional assessment in guiding surgical decision-making in bilateral Wilms tumor. This case illustrates that even massive bilateral WT can be managed successfully through multidisciplinary planning, functional assessment, and individualized surgery, reinforcing the critical role of NSS within the SIOP framework.
Institution: Azerbaijan Medical University
Language: English
Topic: Renal and related cancers
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: gold
OpenAlex ID: W4413825801