Pediatric Surgery International

, Volume 29, Issue 5, pp 419–423 | Cite as

Bilateral Wilms’ tumour in a developing country: a descriptive study

Original Article

Abstract

Purpose

To present our experience of 20 children with bilateral Wilms’ tumour seen in a resource-challenged environment over a 10-year period.

Method

All patients with a diagnosis of bilateral synchronous Wilms’ tumour were identified and recruited.

Results

Study patients represented 11 % of a cohort of 177 new patients with Wilms’ tumour seen over the same period. Three patients had a syndromic predisposition to Wilms’ tumour. Metastatic disease was seen at presentation in four patients (20 %) and three children presented with unilateral tumour rupture. One patient presented with paraplegia and one with obstruction of the duodenum. All children received neoadjuvant chemotherapy. One HIV-infected child died of IRIS after neoadjuvant treatment, but before surgery. One child died of progressive disease after unilateral nephrectomy. Nephron-sparing surgery was performed in 22 kidneys and 15 kidneys were removed in toto. Following enucleation of tumours, three children had positive margins. Discordant histopathology was seen in 53 % of patients. Overall survival at 2 years is 85 %.

Conclusion

Despite significant co-morbidity and advanced disease, bilateral Wilms’ tumour is a treatable disease in a resource-constrained environment.

Keywords

Bilateral Wilms’ tumour Developing country Histopathology 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Paediatric Surgery, Nelson R Mandela School of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa
  2. 2.Department of Telehealth, Nelson R Mandela School of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa
  3. 3.Department of Anatomical Pathology, Nelson R Mandela School of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa

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