Adult-onset Wilm's Tumor: A Case Report

Background Wilm's tumor or nephroblastoma is the most common pediatric renal malignancy whose presentation in adulthood is rare and is often missed. This often results in late presentation and poorer prognosis than childhood variants. Case presentation: This is the case of an eighteen-year-old boy with no relevant birth or medical history who presented with a prolonged history of progressive painful left flank fullness, hematuria, low-grade fever, nausea/vomiting, and weight loss in whom examination also revealed hypertension and left varicocele. Abdominal ultrasound revealed a mixed echogenic left flank mass. Abdominal CT suggested a left renal malignant tumor with inferior vena cava thrombosis, para-aortic lymph node, and lung metastasis presumed to be renal cell carcinoma. Following radical left nephrectomy and histopathological examination, a final diagnosis of stage IV left blastemal-type Wilm's tumor was made. The patient was referred to start adjuvant chemotherapy and localized radiotherapy to the lung and left flank area. Conclusion This report aims to alert clinicians of the possibility of Wilm's tumor in adults with a flank mass. This should allow for early diagnosis and management of this disease variant.