Wilms Tumor in Horseshoe Kidney

Abstract

Introduction: The horseshoe kidney is the most common fusion anomaly. Appears in 1 out of every 400 births, Wilms tumor or Nephroblastoma is the second most frequent abdominal tumor in pediatric age and accounts for more than 90% of kidney tumors in pediatrics. TW is the first example of cancer in which significant cure rates were achieved thanks to multimodal therapies including chemotherapy, radical nephrectomy, and radiation therapy. Objective: To present the clinical case of a patient with a diagnosis of Horseshoe Kidney with unusual presentation of a Wilms Tumor through radical nephrectomy and postoperative chemotherapy using the NTWS 5 protocol. Methods: The report of a 10-year-old male patient with Wilms Tumor in a Kidney in Horseshoe, with review and comparison of the protocols NTWS 5 and S.I.O.P. Result: Radical nephrectomy was performed with neoplasia-free surgical margins without finding metastases to neighboring organs. Adjuvant chemotherapy is given for 24 weeks with complete remission of the disease and adequate kidney function. Conclusions: The objectives of the treatment are to achieve a complete cure with a low drug toxicity and to preserve an adequate renal function. Surgery continues to be the mainstay of treatment, the discussion is focused on the use of neoadjuvant or adjuvant therapy and what the recommended medications and doses should be. All TW patients should receive Adjuvant Chemotherapy. The use of radiotherapy is essential in most cases.