Wilms’ tumor, also known as nephroblastoma, is a rare form of kidney cancer that typically affects infants. It can occur at any stage between infancy and age 14, but is more common in children age 3 to 4. A case of Wilms’ tumor was diagnosed in an infant admitted to the BLK Super Speciality hospital. The experts at the hospital were successful ingiving a new lease of life to the little brave girl who suffered from this cancerous kidney tumour.
Unbearable pain in abdomen for last three month landed 4-year Shruti (name changed) at the hospital. The family did not realize before diagnosis that the little girl was facing a life threatening disease in form of giant tumor- known as Wilms’ tumor. Shruti was fortunate as the critical disease was timely detected by the paediatric surgery and urology team at BLK. The doctors removed the tumor from the kidneys of the girl who suffered from this rare form of kidney cancer.
Shruti had complaints of lump in the abdomen and pain in the abdomen for 3 months. Clinically it was found that she had large well-defined, non-tender mass of size about 14 X 12 cms involving whole of left abdomen and also extending beyond the midline. It was later diagnosed as Wilms’tumor.
“Also known as nephroblastoma, Wilms' tumor is the most common cancer of the kidneys in children. It mostly affects children ages 3 to 4 and becomes much less common after age 5. The child was further investigated and was found to have normal hemogram, normal Liver functions and renal function tests. Ultrasonography and CECT abdomen suggested a large mass largely arising from the antero lateral aspect of left kidney measuring approx 17 x 13 x 10.8 cm (CC) x (TR) x (AP) dimensions” said Dr. Prashant Jain, Senior Consultant - Paediatric Surgery & Paediatric Urology and Coordinator Paediatric Super Specialties, BLK Centre for Child Health.
The condition was traumatic for a child of this age. The lesion revealed a claw sign with the adjacent kidney and multiple prominent intralesional vessels. The lesion was causing mass effect on the adjacent spleen, pancreatic body, tail and stomach with displacement of the adjacent bowel loops to the right and an effaced fat plane with the adjacent intra-abdominal structures. Descending colon was compressed along the anterior aspect of the lesion. These findings on imaging confirmed the diagnosis of Wilms’ tumor.
“In view of complications, we decided to perform left radical nephrectomy. Intraoperatively there was a large mass seen which was arising from the lower pole of the left kidney. The mass was displacing the bowel to the right side, however the left colon was stretched over the mass and dissected off the mass and reflected medially – maintaining the vascularity of the colon. The mass was highly vascular with multiple superficial vessels causing hemorrhage. The mass was handled carefully and dissected according to principles of Wilms’ tumour excision,” said Dr. Prashant Jain.
After the staging of tumor, it was labelled as Stage 2 Wilms’ tumor, and after full recovery she was referred to Pediatric Oncologist to start chemotherapy. Post-surgery the patient responded well and her family was elated. They appreciated efforts of the experts at the BLK Hospital.