Abstract
Adult Wilms tumour is a rare renal malignancy. Although it shares histopathological features with its paediatric counterpart, its genetic landscape and underlying biological behaviour remain incompletely understood. Owing to its rarity, staging and treatment strategies in adults are largely extrapolated from paediatric clinical trials. The adoption of these protocols in adult practice has led to a significant improvement in outcomes over recent decades. Current management relies on a multimodal, risk-adapted approach, incorporating surgery, chemotherapy, and, when indicated, radiotherapy. We present the case of a 30-year-old woman diagnosed with stage I adult Wilms tumour following an atypical clinical presentation. This case underscores the diagnostic and therapeutic challenges associated with Wilms tumour in the adult population and highlights the importance of a multidisciplinary approach to management.