Adult Recurrent Wilms’ Tumor Presenting as a Large Mass: A Case Report and Current Literature Review

Abstract

Wilms tumor (WT) is the most common renal malignancy in children but can be challenging to diagnose in adults because its clinical and imaging features often mimic those of renal cell carcinoma (RCC). Most diagnoses are made incidentally following nephrectomy performed for suspected RCC. Due to the lack of established adult-specific treatment guidelines, management typically follows pediatric protocols. This report presents the case of a 26-year-old woman who presented with abdominal pain, weight loss, and fatigue. Imaging revealed a large, irregular mass in the left kidney, which was confirmed as WT after nephrectomy. She underwent radical nephrectomy followed by adjuvant chemotherapy, including doxorubicin, vincristine, and actinomycin D. After two years of follow-up, recurrence was detected, leading to a second surgery followed by radiotherapy. This case highlights the diagnostic and therapeutic challenges associated with adult WT and emphasizes the need for individualized treatment strategies tailored to each patient.