Second, Peculiar Recurrence of a Wilms Tumor – Pleural And Late

Author(s) :

Andrada Turcas123, Cristina Gheara14, Vlad Galatan1, Cristina Blag5, Dana Cernea 1

1Radiotherapy Department, Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania

2Oncology Department, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

3The European Society for Paediatric Oncology (SIOP Europe), Brussels, Belgium

4Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania

5Clinical Emergency Hospital for Children – Pediatrics Clinic 2, Cluj-Napoca, Romania



Corresponding author: Andrada Turcas, Email:

Published: Volume II, Issue 2, December 2022, 46-51, , , - DOI: 10.53011/JMRO.2022.02.07

Open Access

Full text


December 1, 2022 0 Comments


Nephroblastoma (Wilms tumor) is the most common kidney malignancy in children and one of the most frequent abdominal tumors diagnosed in pediatric patients. We present the case of a 2-year-old boy diagnosed with intermediate-risk, regressive-type nephroblastoma of the left kidney in 2010.  He was treated with neoadjuvant chemotherapy followed by surgery and chemotherapy following the International Society of Pediatric Oncology (SIOP) protocol. After 11 months a metastasis was discovered in the left lung and the patient was (re)classified as being high risk and treated with seven cycles of chemotherapy. After nine disease-free years, the routine follow-up chest CT scan showed a 10/5cm tumor in the left lung involving the pleura. The tumor was completely resected, and pathology confirmed a distal recurrence of nephroblastoma.  The patient was further treated according to the UMBRELLA protocol (BB group) with chemotherapy and local irradiation. The tumor bed was irradiated with 25.2 Gy/14 fr, using Helical Tomotherapy. Following radiotherapy, he received a high dose chemotherapy and autollogus stem-cell transplant, with a good response and without disease recurrence.

Chest CT showing the second pleuro-pulmonary recurrence in the left lung
Figure 2. Dose distribution for the 3 comparative radiotherapy plans –A 3D Conformal Radiotherapy, B Helical Tomotherapy, C- IMAT/VMAT/RapidArc
Notify of
Inline Feedbacks
View all comments