Caracterización, diagnóstico y manejo multidisciplinario del tumor de Wilms o nefroblastoma de presentación tardía: reporte de caso y revisión de la literatura

Wilms tumor, or nephroblastoma, is a renal neoplasm that originates from alterations in renal embryogenesis. It predominantly presents in pediatric patients (with only 3% of cases occurring in adults) and has a significant genetic component, being associated with syndromes such as Denys-Drash, Perlman, and Beckwith-Wiedemann. The initial clinical manifestation is typically an abdominal mass (usually detected at advanced disease stages) accompanied by intermittent hematuria; it may also present with involvement of adjacent organs. The treatment should be multimodal and multidisciplinary, with the mainstays being surgery, chemotherapy, and radiotherapy. The appropriateness and sequence of these treatments are determined based on staging according to international protocols from leading pediatric associations: the Children’s Oncology Group (COG) and the International Society of Pediatric Oncology (SIOP). This report details a case of Wilms tumor in an adult patient, including the description of its clinical and paraclinical features, the surgical approach undertaken, the pathological studies conducted, and the chosen chemotherapy and radiotherapy regimens.