Nsrg-06. brain metastasis in wilms’ tumor: a case report

In children with solid tumors, brain metastasis is relatively uncommon, accounting for only 0.5-1.8% of all pediatric craniocerebral tumors. Wilms’ tumor is the most common abdominal tumor of childhood, and its cerebral metastasis is apparently very rare. We report the case of a 10-year-old boy underwent left nephrectomy for Wilms’ tumor with pulmonary and hepatic metastasis. Treatment after complete resection of the tumor included chemotherapy and radiotherapy. He was referred to our Neurosurgery department six months after initial diagnosis. He complained of frontal headache of increasing severity associated with weightiness in the left hemibody. On admission, his state of consciousness was found to be decreased and he had a left hemiplegia. A cranial computed tomography scan and a cerebral MRI were performed immediately showed an isodense mass in the right frontoparietal region with very little edema. After an intravenous injection of contrast medium there was marked homogenous enhancement of the lesion. A subsequent craniotomy was performed with removal of the neoplasm. Histopathological examination confirmed that it was a metastatic Wilms’ tumor. After the operation, the patient was treated with radiotherapy directed to the whole brain, and additional courses of chemotherapy were given. On a follow up examination 3 month later, the patient remained clinically stable.