Dados do Trabalho

Título

WILMS’ TUMOR (WT) IN AN ADULT PATIENT: A CASE REPORT

Apresentação do caso

A 25-year-old male patient, former smoker, with a positive family history of cancer (uncle with non-melanoma skin cancer) presented, in 2018, a mass in the right kidney, with subsequent radical nephrectomy. The histological diagnosis was Wilms' Tumor (WT), with favorable mixed histology. Tumor pathological staging: NWTS/COG 2. Patient lost follow-up and did not undergo postoperative treatment. In June 2019, the patient experienced pain in the thoracoabdominal transition again, undergoing ultrasonography (USG) and computed tomography (CT) which showed local recurrence of WT. Due to shortage of actinomycin-D, rescue chemotherapy (QT) with vincristine, doxorubicin and cyclophosphamide was then started for 3 cycles every 21 days and referred for surgical evaluation. The patient presented an excellent response to the QT, with tumor reduction from 11 cm to 4 cm, in its largest dimensions. The pathological examination of the surgery showed the absence of neoplasia. Subsequently, the patient underwent radiotherapy to the right hemiabdomen at a dose of 21.6 Gy. Magnetic resonance imaging performed in May 2021 revealed signs of right nephrectomy, with no signs of tumor recurrence/remnant.

Discussão

WT, also called nephroblastoma, is the most common type of kidney cancer in children over 6 months of age, accounting for approximately 85% of all pediatric kidney tumors. In adults, this tumor is extremely rare, representing less than 1%. It has an embryonic mesodermal origin and is composed of 3 basic cell types: epithelium, blastema and stroma. There are no histological differences between WT in adults and children. There are no specific tumor markers for it, nor has an association with lifestyle or environmental factors been described. Since it is quite rare, no standard therapy has been developed for adults, the child protocol is used in this population, with a generally positive response.

Comentários finais

Most adult patients with WT, when properly treated and if the tumor is localized, can be cured, but the diagnosis is usually late in this population, culminating in a more advanced disease and worse prognosis.

Palavras-chave

Wilms’ Tumor, adult

Área

Oncologia - Tumores cutâneos e Sarcomas