Graverán SLA, Verdecia CC, Alonso PM, Pineda FD

Language: Spanish
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ABSTRACT

Introduction: Wilms´tumor (nephroblastoma) is a malignant embryonal tumor of mesodermal lineage, originated in the kidney probably because of abnormal proliferation of the metanephric blasthema. It is tipical of childhood, originating from immature renal remnants and composed by renal blasthema, displasic tubules and mesenchymal or stromal support. It manifests in patients at preschool age, average age of 3.5 years, with asymptomatic palpable abdominal mass of low mobility that does not cross the midline. It can cause macroscopic hematuria and blood hypertension.
Case presentation: female patient, mixed race who is diagnosed with this tumor variant at very small age (just two months); the disease was discovered by her mother, with no apparent clinical signs but great abdominal distension. It was possible to set the diagnosis through fine needle aspiration biopsy which revealed the existence of teratoid Wilms´tumor, an uncommon histological variant. It was proved that this disease could not be treated with the cytoreducing drugs used in the treatment of this neoplasia. The patient was operated on through laparotomy and a big rumor was resected, which occupied the whole left abdominal cavity and crossed into the right one; it measured 28 x 15 x 10 cm of diameter and weighed 1 kilogram.
Conclusions: there are few cases published at pediatric age with this type of neuroblastoma and the importance of surgery to cure the disease is stressed.