ArticleFrontiers in surgery2026
Case Report: Bilateral Wilms tumor with TP53 mutation: a case-based review of clinical challenges.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Bilateral Wilms tumor (BWT) accounts for 5%-7% of all Wilms tumors. BWT presents with an increased complexity and poorer prognosis than unilateral tumors. Currently, the standard treatment involves neoadjuvant chemotherapy combined with nephron-sparing surgery to preserve renal function. While regimens established by leading cooperative groups have improved survival rates, patients with high-risk molecular alterations, such as TP53 mutations, often exhibit intrinsic chemoresistance, complicating their management. We report the case of a 3-year-old girl who presented with intermittent abdominal pain. Imaging demonstrated bilateral stage V WT, with multiple hepatic and pulmonary metastases and extensive lymphadenopathy. She was managed according to the Chinese Children Cancer Group (CCCG)-WT-2019 protocol, receiving neoadjuvant VAD (vincristine, actinomycin D, and doxorubicin) chemotherapy, followed by staged bilateral nephron-sparing surgery. Histopathological examination demonstrated a high-risk, blastemal-predominant WT. Molecular analysis identified a
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