BILATERAL NEPHROBLASTOMA – CASE PRESENTATION
Nephroblastoma is the most common pediatric abdominal malignancy, representing approximately 30% of pediatric cancers.Our case concerns a 3-year-old girl diagnosed with bilateral nephroblastoma, who presented 4 renal tumors, of which one that originated in the left kidney was occupying almost entirely the left half of her abdomen. The patient, D. A., was hospitalized in the surgery department of „Maria Sklodowska Curie” Emergency Children’s Hospital in Bucharest on 10.10.2014 in order to continue investigations regarding a right renal mass discovered incidentally during a routine abdominal echography. An abdominal CT scan revealed 2 masses in her left kidney, the largest of which measured 12/8/9 cm, and another 2 in her right kidney.Clinical and paraclinical data was suggestive for nephroblastoma, so a 4 week combined chemotherapy regimen (Vincristine and Actinomycin D) was initiated. A second abdominal CT showed a significant reduction in the size of the masses, which prompted physicians to repeat the regimen. Afterwards, a third abdominal CT scan showed an even further reduction in size, the largest mass now measuring 49/43 mm.The patient underwent a left ureteronephrectomy on 24.12.2014, along with the excision of the 2 right renal tumors. Postoperatively, a third chemotherapy regimen was initiated, with the same medication, this time lasting 27 weeks. At the time of publishing, the patient is still under chemotherapy treatment. This case presents a few interesting features, highlighting the possibility of a very positive response to treatment of nephroblastoma, despite a dire initial prognosis.