Wilms' tumor in the adult - Report of a case and review of the literature

Wilms' tumor is rare in adults. Its histology, grading and staging are iden tical to those in children. Investigators agree on a combined modality appr oach in the treatment of adult Wilms' tumor (AWT), but differ on how aggres sive it should be. Some advocate adopting the current pediatric protocols w hich take into account tumor stage and grade. Others recommend using advanc ed disease regimens for all stages and grades. We report on an 18 year-old male with stage IV favorable histology Wilms' tumor. The patient underwent radical nephrectomy and received postoperative radiotherapy with intensive four-drug chemotherapy. He had one relapse after 12 months which was succes sfully treated with chemotherapy and radiotherapy. He remains in remission without relapses 36 months after the initial diagnosis. The genetics of Wil ms' tumor has been well studied in children but is practically unknown in a dults; karyotype and molecular genetic studies in this case were normal.