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Fong Disease
Joseph Junewick, MD FACR
over 7 years ago
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Adult Wilms Tumor

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

16 year old female with hematuria, flank pain and abnormal non-contrast CT (Kidney Stone Protocol) at another hospital.


Case Images


Diagnosis

Adult Wilms Tumor

Findings

CT – Axial and multiplanar reformats show a large heterogenously enhancing left intrarenal neoplasm with perirenal hemorrhage and/or rupture. No renal vein involvement, adenopathy or metastatic disease.

Discussion

Wilms tumor (nephroblastoma) is derived from pleuripotent metanephric blastema and is the most common renal neoplasm in children. Peak incidence occurs between 2 and 3 years of age; 80% tumors occur by 5 years of age. Diagnosis after 15 years of age account for 3 % of Wilms tumors and is termed “adult” Wilms tumor. The clinical presentation of adults with Wilms tumor differs from that of children. The main symptom of adults is flank pain, and the majority of them have a history of weight loss and of a sudden drop in performance status. In children, tumors are mainly asymptomatic or children present with a painless swollen abdomen. Histology and treatment are similar between adult and pediatric Wilms tumors.

Reference

Reinhard H, Aliani S, Ruebe C, et al. Wilms’ Tumor in Adults: Results of the Society of Pediatric Oncology (SIOP) 93-01/Society for Pediatric Oncology and Hematology (GPOH) Study. J Clin Onc (2004); 22:4500-4506.



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