Compromiso renal de los pacientes con tumor de Wilms bilateral / Kidney involvement in patients with bilateral Wilms tumor

El tumor de Wilms (TW) es el tumor renal maligno más frecuente en la infancia. Entre el 5-7% de los pacientes se presentan con enfermedad TW bilateral, de forma sincrónica o metacrónica. El TW bilateral generalmente ocurre en pacientes pequeños y más frecuentemente en niñas. La cirugía es un componente crítico en el tratamiento para lograr una alta tasa de curación preservando la mayor cantidad de masa renal. La quimioterapia preoperatoria a menudo reduce significativamente el tamaño del tumor, facilitando la cirugía posterior. Los pacientes con TW bilateral deben ser tratados en centros con experiencia en esta patología. El manejo de estos pacientes es aún un desafío (AU)

Wilms tumor (WT) is the most common malignant kidney tumor in childhood. Between 5-7% of the patients present with synchronous or metachronous bilateral WT. Bilateral WT typically occurs in young patients and most frequently in girls. Surgery is a critical component of the treatment as it has a high rate of cure while preserving the largest kidney mass. Preoperative chemotherapy often significantly reduces the size of the tumor, facilitating subsequent surgery. Patients with bilateral WT should be managed at centers with experience treating this disease. The management of these patients is still a challenge (AU)

The Usefulness of Three Dimensional Reconstruction Imaging using Spiral CT: an Experience in the Bilateral Wilms` Tumor Surgery / 대한비뇨기과학회지

Conventional angiography has been used to identify detailed vascular anatomy for surgery in which parenchymal salvage should be necessary. Recently, we experienced a case in which 3-dimensional CT was very helpful in salvaging the part of the kidney. A 2 year-old girl was diagnosed as bilateral Wilms` tumor. Conventional CT scan showed right huge mass and left upper pole mass of the kidney. The patient was planned to have neoadjuvant chemotherapy. Spiral CT scan with three-dimensional reconstruction was performed after 3-month chemotherapy and detailed anatomical information regarding vessels, tumor mass and normal parenchyma was obtained. Based on these anatomical information, right radical nephrectomy and left partial nephrectomy was successfully performed. Surgical findings was quite similar to that obtained by preoperative 3-dimensional CT images. Three-dimensional reconstruction of spiral CT imaging is considered to be useful in the evaluation of surgical anatomy in kidney-saving surgery preoperatively.

Bilateral Wilms Tumor: A Case Report / 대한비뇨기과학회지

A male child of 9 months with bilateral Wilms tumor was admitted to our hospital. His chief complaint was abdominal mass. Clinical examination and IVP, USG and CT-scan disclosed bilateral Wilms tumor. Right nephrectomy and left partial nephrectomy were performed. Anuria was experienced to 24 hours and so exploratory-laparotomy was done. Renal autotranplantation was performed because of the thrombosis of renal artery. But six days after operation he died.