A case of Wilms tumour recurrance successfully treatment

Abstract

Patients’ survival with nephroblastoma improved dramatically with a multimodal treatment. Wilms tumour (WT) relapses occur during 18  months of follow up in a tumour bad or/and in lungs in most cases.  Herein we present a case of patient with a late nephroblastoma recurrence locally, in irradiated field, and with  metastasis in a right liver lobe. Primary treatment included: urgent  surgery (nephrectomy), irradiation of a tumour bad, paraaortic  lymph nodes, a left abdominal flank (29–33 Gr); and chemotherapy  (vincristine, actinomycin D and adriamycin) according the protocol  SIOP WT 2001 recommendations for stage III. A boy was 5 years old when WT was diagnosed. The patient developed relapse 18 months  later a primary surgery. A tumour’s volume has been decreased  dramatically after 3 courses (ICE – ifosfamide, carboplatin,  etoposide) of neoadjuvant chemotherapy. A left retroabdominal mass, a left ureteral stump and a right liver lobe (V, VI, VII) were  removed during a surgery followed by 2 courses of adjuvant  chemotherapy (ICE). The radiotherapy was avoided because of a primary irradiation. After 18 months of follow up the patient is in a second remission.