Bilateral Wilms tumors (nephroblastoma)

Case contributed by Chris O'Donnell


Parent palpated a mass in the left side of the abdomen. A large firm left-sided mass was clinically evident.

Patient Data

Age: 4 years
Gender: Female

Soft tissue density masses on either side of the abdomen causing extrinsic compression to the bowel.  No calcification.


Solid mass lesions arising from both kidneys (left larger than right) with abnormal blood flow on color Doppler.  No definite renal vein invasion.

Case Discussion

Synchronous bilateral Wilms tumor is rare (5 - 10% of cases) but well recognized, conferring a worse prognosis as surgical excision is much more difficult.  Emphasis is now on neoadjuvant chemotherapy followed by surgery for residual masses.  As far as staging goes, it is described as stage V irrespective of the local staging of each tumor mass.  Presentation is typically delayed as children are asymptomatic. Parental palpation of a mass is the usual scenario.

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