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

## TL;DR

An 11-year-old girl developed a rare ovarian germ cell tumor eight years after being treated for Wilms tumor, highlighting the need for long-term monitoring in cancer survivors.

## Contribution

This case report presents a rare instance of a secondary ovarian germ cell tumor in a Wilms tumor survivor, emphasizing extended surveillance beyond five years.

## Key findings

- An 11-year-old girl developed a stage III ovarian germ cell tumor eight years after Wilms tumor treatment.
- The case underscores the importance of long-term follow-up for late-onset secondary malignancies in Wilms tumor survivors.
- Multidisciplinary management is essential for treating secondary malignancies in pediatric cancer survivors.

## Abstract

Wilms 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.

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.

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.

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

•The patient's initial abdominal mass was later identified as a stage III germ cell tumor.•The case emphasizes the need for follow-up beyond the conventional 5-year period.•Managing secondary malignancies needs a multidisciplinary approach in WT survivors.•It highlights the importance of continuous monitoring in pediatric oncology cases.

The patient's initial abdominal mass was later identified as a stage III germ cell tumor.

The case emphasizes the need for follow-up beyond the conventional 5-year period.

Managing secondary malignancies needs a multidisciplinary approach in WT survivors.

It highlights the importance of continuous monitoring in pediatric oncology cases.