Wilms Tumor with simultaneous Atrial tumor thrombosis and Ureteral Extension

Wilms tumor is the most common renal malignancy in childhood¡ whereas¡ it only consists 1% of adult renal tumors. It is much more difficult to diagnose in adults because of large differential diagnosis of adults renal masses.
A 16 years old female with nonspecific right flank pain was referred. Computerized tomography (CT) scan revealed a large renal mass occupying the right flank area with IVC and intra-ureteral extension. Biopsy also showed a nonspecific spindle cell carcinoma. She underwent an urgent surgery because of intra ventricular extension of the tumor. Pathological assessment also approved the wilms tumor. Regarding the rarity of this lesion in adults¡ they are treated with the current protocols which are recommended for children. Therefore¡ the case was treated with adjuvant chemo-radiotherapy as stage 5a and National Wilms Tumor Study (NWTS) protocols. Unfortunately¡ she had a recurrence in her right lung two years after the surgery which was treated with surgery and chemotherapy. She again had a recurrence four months later which ended up in patient''s death due to stopping the treatment.