Secondary ovarian germ cell tumor following Wilms tumor after eight years post-treatment: A rare case report.

introductionWilms tumor (WT), or nephroblastoma, is a rare pediatric renal malignancy with generally favorable outcomes after multimodal treatment. However, survivors face a risk of developing secondary malignant neoplasms (SMNs), though these are relatively uncommon. This report details a rare case of a secondary germ cell tumor of the ovary occurring in an 11-year-old girl, eight years post-treatment for stage III WT. The case underscores the importance of extended surveillance in WT survivors for detecting late-onset SMNs. PRESENTATION OF CASE: An 11-year-old girl, previously treated for stage III WT with nephrectomy, chemotherapy, and abdominal radiotherapy, presented with abdominal distension. Physical examination revealed a palpable abdominal mass. Imaging studies, including ultrasound and CT scan, identified a large heterogeneous ovarian mass with cystic and necrotic areas, suggestive of malignancy. The mass was surgically excised, and histopathology confirmed a stage III germ cell tumor of the ovary. Due to metastasis to the omentum and lungs, additional surgical interventions, including supracervical hysterectomy and bilateral salpingo-oophorectomy, were performed. DISCUSSION: This case highlights the potential for late-onset SMNs in WT survivors, particularly in patients with a family history of malignancies, emphasizing the need for long-term follow-up beyond the typical five-year period.

conclusionThe delayed appearance of secondary malignancies points to the necessity of multidisciplinary management and vigilant, prolonged surveillance to optimize outcomes for WT survivors.