A rare presentation of antenatally diagnosed Wilms tumor: A case report
DOI:
https://doi.org/10.47338/jns.v13.1302Keywords:
Wilms’ tumor, Antenatal diagnosis, Renal tumorsAbstract
Background: Wilms’ tumor is the most common renal malignancy in children, with a peak incidence between 1 and 4 years of age. The prevalence of antenatal renal tumors is scarce, around 7 in 100,000 live births. We report a case of an antenatally diagnosed Wilms tumor.
Case Presentation: A 2-month-old infant presented with a right renal lump since birth. The antenatal USG done at 35 weeks of gestation, showed an ill-defined heteroechoic area of size 57.3X29.9 mm at the upper pole of the right kidney, with few cystic areas with increased echogenicity. A right nephroureterectomy was done. It was WT1 and Vimentin positive and focally positive for Cyclin D1, whereas negative for Desmin, SMA, and PAX8, thus confirming the histopathological diagnosis of Wilms’ tumor.
Conclusion: Antenatal Wilms’ tumor is rarely detected. A high degree of suspicion and active investigations should be conducted in antenatal and immediate neonatal periods for prompt decision-making and better outcomes.
Downloads
Metrics
References
Ritchey ML, Azizkhan RG, Beckwith JB, Hrabovsky EE, Haase GM. Neonatal Wilms tumor. J Pediatr Surg. 1995;30:856-9.
Vadeyar S, Ramsay M, James D, O’neill D. Prenatal diagnosis of congenital Wilms’ tumor (nephroblastoma) presenting as fetal hydrops. Ultrasound Obstet Gynecol. 2000;16:80-3.
Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics, 2006. CA-ATLANTA. 2006;56(2):106.
Suresh I, Suresh S, Arumugam R, Govindarajan M, Reddy MP, Sulochana NV. Antenatal diagnosis of Wilms tumor. J Ultrasound Med. 1997;16:69-72.
Tomá P, Lucigrai G, Dodero P, Lituania M. Prenatal detection of an abdominal mass by MR imaging performed while the fetus is immobilized with pancuronium bromide. Am J Roentgenol. 1990;154:1049-50.
Applegate KE, Ghei M, Perez-atayde AR. Prenatal detection of a Wilms’ tumor. Pediatr radiol. 1999;29:65-7.
Glick RD, Hicks MJ, Nuchtern JG, Wesson DE, Olutoye OO, Cass DL. Renal tumors in infants less than 6 months of age. J Pediatr Surg. 2004;39:522-5.
Linam LE, Yu X, Calvo-garcia MA, Rubio EI, Crombleholme TM, Bove K, et al. Contribution of magnetic resonance imaging to prenatal differential diagnosis of renal tumors: Report of two cases and review of the literature. Fetal Diagn Ther. 2010;28:100-8.
Sarin YK, Rahul S, Sinha S, Khurana N, Ramji S. Antenatally Diagnosed Wilms’ Tumour – A Case Report. J Neonatal Surg. 2014; 3(1).
Terenziani M, Spreafico F, Collini P, Piva L, Perotti D, Podda M, et al., Adult Wilms tumor: a mono institutional experience and review of the literature. Cancer. 2004; 101(2):289-93.
Breslow NE, Olshan A, Beckwith JB, Green DM. Epidemiology of Wilms’ tumor. Med Pediatr Oncol. 1993; 21:172–81.
Fischbach BV, Trout KL, Lewis J, Luis CA, Sika M. WAGRsyndrome: A clinical review of 54 cases. Paediatr. 2005; (116):984–8.
Niemitz EL, Feinberg AP, Brandenburg SA, Grundy PE, DeBaun MR. Children with idiopathic hemihypertrophy and Beckwith-Wiedemann syndrome have different constitutional epigenotypes associated with Wilms tumor. Am J Hum Genet. 2005;77:887–91.
Dome JS, Coppes MJ, Recent advances in Wilms tumor genetics, Curr Opin Pediatr. 2002; 14:5–11.
Maiti S, Alam R, Amos CI, Huff V. Frequent association of beta-catenin and WT1 mutations in Wilms tumors. Canc Res. 2000; 60:6288–92.
Coppes MJ. Serum biological markers and paraneoplastic syndromes in Wilms tumor. Med Pediatr Oncol. 1993; 21:213–21.
Kajal P, Rattan KN, Bhutani N, Marwah N. Wilms’ tumor: histopathological variants and the outcomes of 31 cases at a tertiary care center in Northern India. Middle East J Cancer. 2017;8(3):143-50.
Bhutani N, Kajal P, Sharma U. Many faces of Wilms Tumor: Recent advances and future directions. Ann Med Surg. 2021; 64:102202.
Shamberger RC, Anderson JR, Breslow NE, Perlman EJ, Beckwith JB, Ritchey ML et al. Long-term outcomes for infants with very low risk Wilms tumor treated with surgery alone in National Wilms tumor Study-5. Ann Surg. 2010;251:555-8.
Jain V, Mohta A, Sengar M, Khurana N. Is antenatal detection of Wilms' tumor a bad prognostic marker? Indian J Med Paediatr Oncol. 2011;.32:214-6.
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pradeep Kajal, Namita Bhutani, Bhaswati Bharadwaj
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.