Lung metastasis at initial presentation in a 3 year old girl with stage IV Wilms tumor

Abstract

Background: Wilms tumor (nephroblastoma) is a malignant pediatric tumor that arises from mesodermal embryological precursors of renal parenchyma. Lung metastasis as the first presentation of nephroblastoma occurs in 20% of cases. However, haematogenous spread to the lungs or to regional lymphnodes from a previously diagnosed nephroblastoma occurs in of 85% of cases.

Case report: A 3-year old girl presented at children emergency unit with cough and weight loss. Examination revealed an emaciated child, with a huge, right sided abdominal mass. Abdominal ultrasound scan showed a heterogenous, spherical mass with irregular anechoic areas and echogenic solid areas in kidney. Chest radiograph revealed bilateral cannon ball opacities. A diagnosis of nephroblastoma with lung metastasis was made. She underwent combined therapy but relapsed one year later.