Asymptomatic adult Wilms' tumor: A case report

Abstract

Wilms' tumor, also called nephroblastoma, is an extremely uncommon kidney tumor of adulthood. We reported a adult man with a left kidney mass diagnosed as Wilms' tumor. Case presentation: A 25-year-old man was hospitalized due to injury of the anterior cruciate ligament of the right knee. Preoperative imaging accidentally revealed a mass measuring 53 × 46 mm involving the middle and lower segments of the left kidney without evidence supporting the invasion of the surrounding structures or metastasis. The patient didn't show any symptom commonly occurred in Wilms' tumor, such as flank pain or hematuria. After nephrectomy, the diagnosis of adult Wilms' tumor was confirmed based on the tumor morphology and immunohistochemical findings. Conclusion: In adult patients without any clinical manifestations or favorable imaging findings for low-stage renal cell carcinoma, the diagnosis of Wilms' tumor should be taken into consideration.

Keywords: Adult; Case report; Nephroblastoma; Wilms' tumor.

Fig. 1

Computed tomography (CT) images of our patient. On non-contrast enhanced CT, a heterogeneous solid-cystic mass was revealed in the middle and lower part of the left kidney (A,B) with nodular calcification (arrows in B). On the contrast enhanced CT, the solid lesion was enhanced during the cortical (C), medullary (D) and delayed (E) phases, but the cystic component was not enhanced. The blood vessels were indicated in the Maximum Intensity Projection images CT (arrows in F).

Fig. 2

Patholigical findings of the adult Wilms' tumor. The gross specimen (A) and Hematoxylin and Eeosin(H&E) stainings of the current Wilms' tumor were demonstrated at 100 (B), 200 (C) and 400X (D) magnifications.