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Abstract

Teratoid Wilms� tumor is an uncommon variant of the widely encountered pediatric nephroblastoma in which predominant percentage of heterologous tissue are detected. I report a case of teratoid Wilms� tumor in a 6-year-old female. The girl was presented with right sided flank swelling of six month duration which was palpable on physical examination. Abdominal ultrasound showed a mass in the mid and lower poles of the right kidney measuring 10x7x8 cm with minute areas of cystic degeneration and hyperechoic calcific foci. No intravascular echogenic focus was identified on color Doppler sonography. Left kidney was normal in shape, position and echopattern. Post contrast computed tomography scan of chest abdomen and pelvis revealed confirmed the US results. Pre-operative routine investigations were normal. A provisional diagnosis of Wilms� tumor was made followed by right sided nephrectomy and the specimen was sent for the histopathological examination. On gross examination, the tumor measured 11x9x8 cm and was weighing 350 g. It was well- circumscribed and encapsulated. Cut sections presented homogenous gray-white tumor tissue, soft, and granular in the texture. Ureter and renal veins were free from tumor involvement. Microscopically multiple sections examined from different areas showed classic triphasic combination of blastemal (small, round blue cells), stromal (fibrous), and epithelial cell (aborted tubules and glomeruli) types. The heterologous elements are predominant and composed of squamous epithelium with abun-dant keratin pearl formation, rhabdomyoblasts, mature cartilage, mucinous epithelium and neurofibrillary matrix; altogether constituting about 80% of the area from where the sections were examined. Considering the above histopathological features, a diagnosis of teratoid Wilms� tumor was concluded. The patient was referred to the medical oncology department where no post-operative chemotherapy was advised. Patient was doing well 1 year post-surgery. After that, the patient was not in contact for further follow-up.

Biography

I have completed my post- graduation at the age of 24 years from Mansoura University and MD degree from Benha University, Egypt. I have published 33 papers in reputed journals.