Multidisciplinary Care of Adult Wilms' Tumor During Pregnancy: A Case Report and Review of the Literature

While Wilms’ tumor (WT), or nephroblastoma, is the most common pediatric tumor, it is rarely seen in adults and represents less than 1% of all renal neoplasms. The diagnosis of WT during pregnancy is rarer yet and requires a multidisciplinary approach between surgery, radiation, obstetrics/maternal fetal medicine, pediatrics and medical oncology with special consideration for the safety of both the patient and the fetus. We report a clinical case of a pregnant patient with a localized WT who underwent nephrectomy, chemotherapy during pregnancy, Cesarean section followed by post-partum chemotherapy and radiation therapy without evidence of disease recurrence in the year since completing therapy. We also conducted a review of the sparse published data on the optimal treatment of WT in pregnancy. Our case demonstrates a treatment plan for WT diagnosed during pregnancy when the patient requires systemic therapy prior to delivery.