Synchronous bilateral Wilms' tumor with liver metastasis

BMC Urol. 2021 Jun 10;21(1):91. doi: 10.1186/s12894-021-00859-8.


Background: Wilms' tumor (nephroblastoma) is mostly unilateral; however, bilateral Wilms' tumors are seen in about 5-8% of patients. This can be synchronous or metachronous. It is uncommon to get liver metastasis from bilateral Wilms' tumor.

Case presentation: An 8-year-old male Ugandan presented with a history of abdominal swelling and flank pains for 1 year. There was no history of hematuria. Both ultrasound and computed tomography of the abdomen demonstrated multiple solid lesions in both kidneys and a huge solid mass in segments V, VI, VII and VIII of the liver. Histological examination of renal biopsy specimen was favorable for chemotherapeutic regimens. However, following a multidisciplinary tumor board consensus, a nephron-sparing surgery was deemed unsuitable, and he was managed conservatively with chemotherapy (adriamycin and vincristine) with a palliative intent.

Conclusions: Metastatic bilateral Wilms' tumor has a particularly poor prognosis. There are no clear evidence-based guidelines for the management of this rare presentation. This patient benefited from early palliative care and symptom management.

Keywords: Bilateral Wilms’ tumor; Liver metastases; Management challenge; Synchronous.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Humans
  • Kidney Neoplasms / pathology*
  • Liver Neoplasms / secondary*
  • Male
  • Wilms Tumor / secondary*