Salvage therapy in metastatic Adult Wilms' tumor


  • Nancy A. Dawson MD,

    Corresponding author
    1. Division of Hematology and Oncology. Walter Reed Army Medical Center, Washington, DC and the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
    • Department of Hematology/Oncology, Walter Reed Army Medical Center. Washington, DC 20307–5001
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  • Michael A. Klein MD,

    1. Department of Pathology, Columbia Regional Hospital, Columbia, Missouri
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  • H. Grant Taylor MD

    1. Memphis Cancer Clinic, University of Tennessee, Memphis, Tennessee
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Adult Wilms' tumor is a rare and aggressive malignancy. Despite multimodality therapy for all stages of disease, the majority of patients develop fatal metastases. Little information is available on effective salvage therapy. The current report describes a 38-year-old man who had Stage I disease. Pulmonary metastases developed after radical nephrectomy and tumor bed irradiation while receiving adjuvant chemotherapy. He achieved a complete remission lasting 8 months with a combination chemotherapy regimen of cyclophosphamide, vinblastine, dactinomycin, and cisplatin. After isolated pulmonary relapse, he received whole-lung irradiation and remained disease-free 4.5 years after diagnosis. The previously reported results of therapy in metastatic or unresectable adult Wilms' tumor are reviewed, and the current case of effective salvage therapy is documented.