Vedaswari PD, Ariawati K. Wilms tumor with multiple bone and lung metastases in a two-year-old boy. J Case Rep Images Oncology 2017;3:52–56.
Wilms tumor is the most common renal tumor encountered in children with more than 80% was diagnosed below the age of five years. The incidence of metastases of Wilms tumor is approximately 10%. The primary distant site for metastases is the lung; hepatic and lymph nodal metastases are much less common and bone metastases being extremely rare.
We present a two year-old boy with masses on the head, right shoulder and right knee with history of palpable masses two month before on his left abdomen and underwent a nephrectomy. The microscopic examination after tumor excision showed unfavorable Wilms tumor but he never went for chemotherapy. Chest X-ray revealed a solitary nodule on the right paracardiac region and the destruction of the right scapular bone very likely the process of metastases. Computed tomography scan of head revealed soft tissue masses and destructed bone underneath. Microscopic examination in biopsy of the masses at head and right shoulder revealed hypercellular groups of neoplastic cells suitable for small round cell tumor suggests a metastasis of Wilms tumor. He planned to have 24 weeks of chemotherapy consist of doxorubicin, vincristine, cyclophosphamide, and etoposide. After 17 weeks of treatment, he experienced clinical improvement.
Metastases to the bone and lung in Wilms tumor are extremely rare. The manifestation can be as a mass with destructed bone underneath with cytomorphology suitable for small round cell tumor.
Bone metastases, Children, Lung metastases, Wilms tumor
Putu Diah Vedaswari – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ketut Ariawati – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
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Authors declare no conflict of interest.