Vol. 8, Issue 1, Part A (2026)

Advances in pediatric oncology have markedly improved survival rates; however, long-term endocrine and metabolic sequelae remain frequent among survivors. Gonadal dysfunction and metabolic disorders represent significant late effects, particularly in patients exposed to intensive chemotherapy, radiotherapy, and hematopoietic stem cell transplantation at an early age. We report the case of a male adolescent survivor of bilateral nephroblastoma diagnosed in infancy and treated with surgery, high-dose chemotherapy, and autologous bone marrow transplantation, who later developed hypergonadotropic hypogonadism, azoospermia, obesity, insulin resistance, dyslipidemia, and hepatic steatosis. This case highlights the complex interplay between gonadal failure and metabolic complications in childhood cancer survivors and underscores the importance of long-term, multidisciplinary follow-up. Early identification of endocrine dysfunction, timely hormonal replacement, metabolic intervention, and counseling regarding fertility preservation are essential to optimize health outcomes and quality of life in this growing population.