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Traumatic Rupture of Wilm’s Tumour in Children, Case Report of 3.5 Years Girl
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Urology Department, National Medical Institute, Damanhour, Egypt
Anasthesia Department, National Medicine Institute, Damanhour, Egypt
Urology Department, Prince Abdelmohsen Hospital, Ula, Kingdom of Saudi Arabia
- 1 Urology Department, National Medical Institute, Damanhour, Egypt
- 2 Urology Department, National Medical Institute, Damanhour, Egypt
- 3 Urology Department, National Medical Institute, Damanhour, Egypt
- 4 Urology Department, National Medical Institute, Damanhour, Egypt
- 5 Urology Department, National Medical Institute, Damanhour, Egypt
- 6 Urology Department, National Medical Institute, Damanhour, Egypt
- 7 Urology Department, National Medical Institute, Damanhour, Egypt
- 8 Urology Department, National Medical Institute, Damanhour, Egypt
- 9 Anasthesia Department, National Medicine Institute, Damanhour, Egypt
- 10 Urology Department, Prince Abdelmohsen Hospital, Ula, Kingdom of Saudi Arabia
Open Journal of Urology·Volume 16 (2026)·Pages 239–247·Published 13 May 2026·DOI10.4236/oju.2026.165023
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Abstract
Background: We report a case of a 3.5-year-old girl presenting with hemorrhagic shock and gross heamaturia. Emergency evaluation via ultrasound and CT revealed a large perinephric hematoma and a non-secretory left kidney. Due to hemodynamic instability, an emergent laparotomy and radical nephrectomy was performed. Results: Histopathology confirmed a Stage III mixed-type Wilms tumor. The upgrade to Stage III was necessitated by intraoperative tumor rupture and local spillage. Despite a postoperative complication of intestinal obstruction, the patient successfully completed the SIOP-based chemotherapy and radiotherapy protocol and remains recurrence-free at one-year follow-up. Conclusion: Traumatic rupture of a Wilms tumor is a surgical emergency. Immediate intervention and upstaging to Stage III are critical for survival and long-term oncological control.
KeywordsWilms TumorBlunt Renal TraumaHemorrhagic ShockRadical NephrectomySIOP Staging
- van den Heuvel-Eibrink, M.M., Hol, J.A., Pritchard-Jones, K., van Tinteren, H., Furtwängler, R., Verschuur, A.C., et al . (2017) Rationale for the Treatment of Wilms Tumour in the UMBRELLA SIOP-RTSG 2016 Protocol. Nature Reviews Urology , 14, 743-752. https://doi.org/10.1038/nrurol.2017.163
- Anwar, S., Saadia, M., Faizan, M., et al . (2024) Effect of Preoperative Chemotherapy in Reduction of Tumor Volume in Wilms Tumor in Relation to Histology. Annals of King Edward Medical University , 30, 6-11. https://doi.org/10.21649/akemu.v30i1.5245
- Charlton, J., Pavasovic, V., & Pritchard-Jones, K. (2015) Biomarkers to Detect Wilms Tumors in Pediatric Patients: Where are We Now? Future Oncology , 11, 2221-2234. https://doi.org/10.2217/fon.15.136
- Vujanić, G.M., Sandstedt, B., Harms, D., Kelsey, A., Leuschner, I. and de Kraker, J. (2002) Revised International Society of Paediatric Oncology (SIOP) Working Classification of Renal Tumors of Childhood. Medical and Pediatric Oncology , 38, 79-82. https://doi.org/10.1002/mpo.1276
- Amparore, D., Piramide, F., Pecoraro, A., Verri, P., Checcucci, E., De Cillis, S., et al . (2022) Identification of Recurrent Anatomical Clusters Using Three-Dimensional Virtual Models for Complex Renal Tumors with an Imperative Indication for Nephron-Sparing Surgery: New Technological Tools for Driving Decision-Making. European Urology Open Science , 38, 60-66. https://doi.org/10.1016/j.euros.2022.02.006
- Sethi, S.K., Bunchman, T., Chakraborty, R. and Raina, R. (2021) Pediatric Acute Kidney Injury: New Advances in the Last Decade. Kidney Research and Clinical Practice , 40, 40-51. https://doi.org/10.23876/j.krcp.20.074
- Guzzo, T.J., Kovell, R.C., Ziemba, J.B., Weiss, D.A. and Wein, A.J. (2023) Penn Clinical Manual of Urology. Elsevier Health Sciences.
- Guzzetta, N.A., Faraoni, D. and Josephson, C.D. (2023) Hemostasis Management of the Pediatric Surgical Patient. Elsevier.
- Duan, X.H., Zhang, M.F., Ren, J.Z., Han, X.W., Chen, P.F., Zhang, K., et al . (2016) Urgent Transcatheter Arterial Embolization for the Treatment of Ruptured Renal Angiomyolipoma with Spontaneous Hemorrhage. Acta Radiologica , 57, 1360-1365. https://doi.org/10.1177/0284185115588125