Function-guided renal parenchyma preservation in a giant bilateral Wilms tumor following SIOP-2016–based multistage chemotherapy and staged surgery: a case-based review

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Synchronous bilateral Wilms tumor (BWT) demands oncologic control while protecting lifelong kidney function. In mesenchymal-predominant tumors, radiologic shrinkage after neoadjuvant therapy may be minimal and can mislead size-based surgical sequencing. In BWT with discordant radiologic response, split renal function can decisively guide sequencing and expand nephron preservation.