A 33-year-old woman, known since January 2003, came to the hospital for presenting a mass of 8 cm in size of the right mesoregion, accompanied by retrocaval adenomegaly and bilateral metastases, as well as various solid lung nodules dependent.
Percutaneous renal biopsy revealed nephroblastoma.
It was staged as IV and according to the SIOP protocol, 6 cycles of systemic polychemotherapy with actinomycin D, vincristine and doxorubicin were administered separated 3 weeks.
At the end of this period, there was a reduction in renal mass and an evident change in density of the hepatic nodule, with no variation in size or density of regional lymph nodes.
She underwent radical nephrectomy, regional lymphadenectomy and excision of a hepatic nodule.
In kidney was confirmed the existence of nephroblastoma with mixed component, a third of blastema, and 2 epithelial thirds, accompanied by 60% necrosis.
After nephrectomy, the patient continued with cycles of actinomycin D and creatine, until in a control study a basal pulmonary nodule appeared, studied by PET, showing a positive pattern, with no apparent growth component requiring resection.
Subsequently, following the indications of the SIOP, systemic polychemotherapy associated with platinum and etoposide was continued for up to 26 weeks.
At present 46 months after the initial diagnosis is free of disease.
