Atypical presentation of Wilms’ tumor in an adult: a case report and diagnostic considerations

Abstract Wilms’ tumor (WT), while common in pediatric populations, is exceedingly rare in adults, accounting for only 0.5% of renal neoplasms. This report describes a 44-year-old patient diagnosed with stage II WT in the left kidney who underwent a radical nephrectomy, illustrating the diagnostic challenges encountered in adult cases. The patient’s symptoms and radiological findings were non-specific, complicating early detection. Histopathological analysis revealed a mixed-type tumor with a 60% blastemal component. Accurate histopathological evaluation is crucial for determining prognosis and guiding treatment. This case is rare due to its early-stage (stage II) diagnosis in an adult, which is almost unheard of in the literature, where most adult WT are advanced. This highlights the critical need for heightened clinical suspicion, early diagnostic efforts, and pivotal surgery-based treatment to improve outcomes in such rare cases.