Wilms’ Tumor With Transureteric Extension Into Bladder

Abstract

We report a case of 15 months old boy with Wilms' tumor with transureteric extension of the tumor into the bladder. His chief complaint was passage of brownish yellow pasty like material per urethrally. Examination revealed a mass in the right flank. CT scan showed a large mass arising from the right kidney and extending down the right dilated ureter into the bladder. A radical right nephroureterectomy was performed. Histopathology revealed triphasic nephroblastoma without invasion of ureteric wall or nodal metastasis. The tumor was classified as Cassady stage 1 Wilms' tumor and hence did not require adjuvant chemotherapy or radiotherapy. If clinically suspicious of ureteric extension of tumor and if imaging does not pick it or is unclear, cystoscopy and retrograde pyelogram are recommended to prevent transecting unsuspected tumor in ureter which will upstage the tumor.