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Alijani B, Abbaspour E, Karimzadhagh S, Reihanian Z, Haghani Dogahe M, Jafari M, Jafari S, Zaresharifi N. First incidence of extrarenal wilms tumor within the spinal canal in the adult population: a novel case report and literature review. BMC Urol 2024; 24:119. [PMID: 38858693 PMCID: PMC11163749 DOI: 10.1186/s12894-024-01508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Wilms tumor (WT), also known as nephroblastoma, is rare in adults, accounting for merely 3% of all nephroblastomas or 0.2 cases per million individuals. Extrarenal Wilms tumor (ERWT) emerges outside the renal boundaries and comprises 0.5 to 1% of all WT cases, with even rarer incidences in adults. Oncogenic mutations associated with ectopic nephrogenic rests (NR) may contribute to ERWT development. Diagnosis involves surgical resection and pathology examination. Due to scarce cases, adults often rely on pediatric guidelines. We thoroughly searched PubMed, Scopus, and Web of Science databases to establish our case's uniqueness. To the best of our knowledge, this is the first documented incidence of extrarenal Wilms tumor within the spinal canal in the adult population. CASE PRESENTATION A 22-year-old woman with a history of congenital lipo-myelomeningocele surgery as an infant presented with a 6-month history of back pain. This pain gradually resulted in limb weakness, paraparesis, and loss of bladder and bowel control. An MRI showed a 6 × 5 × 3 cm spinal canal mass at the L4-S1 level. Consequently, a laminectomy was performed at the L4-L5 level to remove the intramedullary tumor. Post-surgery histopathology and immunohistochemistry confirmed the tumor as ERWT with favorable histology without any teratomatous component. CONCLUSION This report underscores the rarity of extrarenal Wilms tumor (ERWT) in adults, challenging conventional assumptions about its typical age of occurrence. It emphasizes the importance of clinical awareness regarding such uncommon cases. Moreover, the co-occurrence of spinal ERWTs and a history of spinal anomalies warrants further investigation.
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Affiliation(s)
- Babak Alijani
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abbaspour
- Department of Radiology, Poursina Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Sahand Karimzadhagh
- Clinical Research Development Unit of Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Zoheir Reihanian
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Maryam Jafari
- Student Research Committee, School of Medicine, Anzali International Campus, Guilan University of Medical Sciences, Rasht, Iran
| | - Seifollah Jafari
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nooshin Zaresharifi
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, 41937-13194, Iran.
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Silverii H, Nelson N, Kieran K, Cain M. A Surprise During "Routine" Orchidopexy: An Extrarenal Wilms Tumor Case Report. Urology 2024; 184:e250-e252. [PMID: 38052323 DOI: 10.1016/j.urology.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023]
Abstract
We present the case of a 12-month-old male diagnosed with an extrarenal Wilms tumor found incidentally at the time of inguinal orchiopexy. He was staged and treated according to Children's Oncology Group (COG) protocol, with no evidence for disease at the end of treatment. We review the patient's presentation and treatment course, followed by a review of current literature on extrarenal Wilms tumor and considerations for management.
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Affiliation(s)
- Hailey Silverii
- Seattle Children's Hospital, Seattle, WA; Division of Urology, Seattle Children's Hospital, Seattle, WA.
| | - Nya Nelson
- Seattle Children's Hospital, Seattle, WA; Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, WA
| | - Kathleen Kieran
- Seattle Children's Hospital, Seattle, WA; Division of Urology, Seattle Children's Hospital, Seattle, WA
| | - Mark Cain
- Seattle Children's Hospital, Seattle, WA; Division of Urology, Seattle Children's Hospital, Seattle, WA
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Li T, Wang H, Chen X, He L. Case report: The CT features of pediatric retroperitoneal extrarenal Wilms tumor: a report of two cases and literature review. Front Pediatr 2023; 11:1161603. [PMID: 37287632 PMCID: PMC10243548 DOI: 10.3389/fped.2023.1161603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Retroperitoneal extrarenal Wilms tumor is a rare condition in children that can be easily misdiagnosed as other retroperitoneal malignancies unrelated to the renal origin. Computerized tomography scan plays a crucial role in diagnosing and distinguishing retroperitoneal malignancies. In this report, we present two cases of retroperitoneal extrarenal Wilms tumor in children who were admitted due to abdominal mass. Laboratory examination did not reveal any significant abnormality. However, a computerized tomography scan revealed a solid or cystic-solid mass in the retroperitoneum accompanied by a bone spur extending from the anterior edge of the vertebral body to the back of the mass, while the origin of the tumor remained unclear. By analyzing these two cases and reviewing previous studies on retroperitoneal extrarenal Wilms tumor in children, we summarized the clinical and imaging characteristics of this rare condition. We also found that the presence of a spinal deformity adjacent to the mass might indicate the possibility of a retroperitoneal extrarenal Wilms tumor.
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Karim A, Shaikhyzada K, Abulkhanova N, Altyn A, Ibraimov B, Nurgaliyev D, Poddighe D. Pediatric Extra-Renal Nephroblastoma (Wilms' Tumor): A Systematic Case-Based Review. Cancers (Basel) 2023; 15:cancers15092563. [PMID: 37174029 PMCID: PMC10177564 DOI: 10.3390/cancers15092563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Wilms Tumor (WT) is one of the most common renal tumors in the pediatric population. Occasionally, WT can primarily develop outside the kidneys (Extra-Renal Wilms Tumor, ERWT). Most pediatric ERWTs develop in the abdominal cavity and pelvis, whereas the occurrence of this tumor in other extra-renal sites represents a minor part of ERWT cases. In addition to describing a case of spinal ERWT (associated with spinal dysraphism) in a 4-year boy (to add a further clinical experience on this very rare pediatric tumor), we performed a case-based systematic literature review on pediatric ERWT. We retrieved 72 papers providing enough information on the diagnosis, treatment, and outcomes of 98 ERWT pediatric patients. Our research highlighted that a multimodal approach involving both chemotherapy and radiotherapy, after partial or complete tumor resection in most cases, was typically used, but there is no standardized therapeutic approach for this pediatric malignancy. However, this tumor may be potentially treated with a better success rate if the diagnostic confirmation is not delayed, the mass can be totally resected, and an appropriate and, possibly, tailored multimodal treatment can be promptly established. In this regard, an international agreement on a unique staging system for (pediatric) ERWT is definitely needed, as well as the development of international research, which may be able to gather several children diagnosed with ERWT and, possibly, lead to clinical trials which should also include developing countries.
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Affiliation(s)
- Akzhol Karim
- Program of Solid Oncology, Section of Pediatric Oncology, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Kundyz Shaikhyzada
- Program of Solid Oncology, Section of Pediatric Oncology, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Nazgul Abulkhanova
- Program of Solid Oncology, Section of Pediatric Oncology, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Akzhunis Altyn
- Program of Solid Oncology, Section of Pediatric Oncology, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Bakytkali Ibraimov
- Section of Pathology, Clinical Academic Department of Laboratory Medicine, Republican Diagnostic Center, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Dair Nurgaliyev
- Section of Pediatric Oncology, Clinical Academic Department of Pediatrics, University Medical Center (UMC), Astana 010000, Kazakhstan
| | - Dimitri Poddighe
- Associate Professor of Pediatrics, School of Medicine, Nazarbayev University, Kerei-Zhanibek Str. 5/1, Astana 010000, Kazakhstan
- Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center (UMC), Astana 010000, Kazakhstan
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Willis KR, Sathe AA, Xing C, Koduru P, Artunduaga M, Butler EB, Park JY, Kurmasheva RT, Houghton PJ, Chen KS, Rakheja D. Extrarenal Anaplastic Wilms Tumor: A Case Report With Genomic Analysis and Tumor Models. J Pediatr Hematol Oncol 2022; 44:147-154. [PMID: 35129140 PMCID: PMC9035038 DOI: 10.1097/mph.0000000000002413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022]
Abstract
Primary extrarenal Wilms tumors are rare neoplasms that are presumed to arise from metanephric or mesonephric remnants outside of the kidney. Their pathogenesis is debated but has not been studied, and there are no reports of genomic descriptions of extrarenal Wilms tumors. We describe a diffusely anaplastic extrarenal Wilms tumor that occurred in the lower abdomen and upper pelvis of a 10-year-old boy. In addition to the clinical, histopathologic, and radiologic features, we describe the cytogenetic changes and exomic profile of the tumor. The tumor showed loss of the tumor suppressor AMER1, loss of chromosome regions 1p, 16q, and 22q, gain of chromosome 8, and loss of function TP53 mutation-findings known to occur in renal Wilms tumors. This is the first description of the exomic profile of a primary extrarenal Wilms tumor. Our data indicate that primary extrarenal Wilms tumors may follow the same pathogenetic pathways that are seen in renal Wilms tumors. Finally, we describe the establishment of first ever tumor models (primary cell line and patient-derived xenograft) from an extrarenal Wilms tumor.
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Affiliation(s)
| | - Adwait A Sathe
- Eugene McDermott Center for Human Growth and Development
| | - Chao Xing
- Eugene McDermott Center for Human Growth and Development
- Division of Pediatric Radiology, Department of Radiology
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
| | | | - Maddy Artunduaga
- Division of Pediatric Radiology, Department of Radiology
- Children's Health System of Texas, Dallas
| | - Erin B Butler
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
| | - Jason Y Park
- Departments of Pathology
- Children's Health System of Texas, Dallas
| | - Raushan T Kurmasheva
- Greehey Children's Cancer Research Institute
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX
| | - Peter J Houghton
- Greehey Children's Cancer Research Institute
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX
| | - Kenneth S Chen
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
- Children's Health System of Texas, Dallas
| | - Dinesh Rakheja
- Departments of Pathology
- Children's Health System of Texas, Dallas
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Liang H, He Y, Fu L, Tian J, Sun N, Yu T, Huang Y, Lin D, Wang G. Extrarenal Wilms tumor in children: A retrospective observational case series. J Pediatr Urol 2020; 16:664.e1-664.e7. [PMID: 32758416 DOI: 10.1016/j.jpurol.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Pediatric extrarenal Wilms tumor (ERWT) is rare. The diversity of clinical characteristics makes diagnosis, treatment and judging the prognosis difficult. Long-term follow-up outcomes and the possible prognostic factors of ERWT are still insufficient. OBJECTIVE To identify the characteristics, therapeutic strategies and long-term results of pediatric ERWT. PATIENTS AND METHODS All children with ERWT in our institution were retrospectively reviewed. The National Wilms Tumor Study (NWTS) system was used to evaluate tumor grade. RESULTS Among the 876 patients with Wilms tumor in our institution between January 1986 and July 2018, 5 (0.57%) patients had ERWT. Of the 5 children with ERWT, the locations were the retroperitoneum in 3 patients (including 1 presacral) and the gubernaculum testis of an undescended testis and a duplicate sigmoid colon in 1 patient each. Two patients were stage II, and 3 patients were stage III. The three patients with larger tumor sizes had preoperative tumor rupture. In the long-term follow-up, ranging from 1.0 to 10.8 years, 3 patients had disease-free survival, and 2 patients with older age, a larger tumor size and preoperative tumor rupture had recurrence with metastasis, including 1 death. DISCUSSION Wilms tumor extremely rarely originates outside the kidney. The current case series represents the first report of ERWT accompanied by a duplicate sigmoid colon. ERWT can coassociate with congenital gastrointestinal and genitourinary system anomalies, such as undescended testis and duplicate sigmoid colon, which provide clues to the preoperative diagnosis of ERWT. Deep and not easily palpated locations for the ERWT and older ages were associated with diagnosis delay, which can lead to enlargement of the tumor, an increased risk of preoperative tumor rupture and advancement of the tumor stage. Although only 3% of ERWT cases were metastatic according to previous reports, 2 of 5 patients (patients 1 and 4) with older age, larger tumor size and preoperative tumor rupture had recurrence and metastases in the current study. Thus, patients with poor prognoses often require aggressive combination treatments, and more attention is needed in terms of the recurrence, metastases and fatality of ERWT. CONCLUSION ERWTs are rare tumors and can coassociate with congenital gastrointestinal and genitourinary system anomalies. The prognosis of ERWT is comparable to that of Wilms tumor located at normal anatomical sites.
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Affiliation(s)
- Haiyan Liang
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yuzhu He
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Libing Fu
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jun Tian
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Ning Sun
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Tong Yu
- Imaging Center, Beijing, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yangyue Huang
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Defu Lin
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Guannan Wang
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
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7
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Cao MM, Huang CP, Wang YF, Ma DM. Extrarenal Wilms' Tumor of the Female Genital System: A Case Report and Literature Review. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2017; 32:274-278. [PMID: 29301605 DOI: 10.24920/j1001-9294.2017.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Extrarenal Wilms' Tumors (ERWTs) are rare. There have been only 25 cases of ERWT arising from the female genital system reported in the literature. In this paper, we report a 60-year-old woman with a complaint of vaginal bleeding and a polypoid mass in the uterine cavity by sonography that was demonstrated as ERWT by pathology after resection. The pathological characteristics, histological origination, diagnosis, therapy and prognosis of ERWT in female reproductive system are discussed in this paper in the purpose of improving the diagnosis and therapy of this rare tumor.
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Affiliation(s)
- Min-Min Cao
- Department of Gynaecology, the Second Hospital of Shandong University, Jinan 250000, China
| | - Cui-Ping Huang
- Department of Gynaecology, the Second Hospital of Shandong University, Jinan 250000, China
| | - Ya-Fen Wang
- Department of Gynaecology, the Second Hospital of Shandong University, Jinan 250000, China
| | - De-Mei Ma
- Department of Gynaecology, the Second Hospital of Shandong University, Jinan 250000, China
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Xing T, Deng S, Lu M, Qiu M, Tian X, Ma L. WITHDRAWN: Sacroanterior extrarenal Wilms tumor: Case report and literature review. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Extra-renal, blastemal-predominant, Wilms tumor. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2016. [DOI: 10.1016/j.phoj.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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10
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Extrarenal retroperitoneal Wilms' tumor with subsequent pulmonary and peritoneal metastasis in a 4 year-old girl: A case report and review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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11
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Extrarenal Wilms tumor: a case report and review of the literature. J Pediatr Surg 2013; 48:E33-5. [PMID: 23845655 DOI: 10.1016/j.jpedsurg.2013.04.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 02/06/2023]
Abstract
Extrarenal Wilms tumors are extremely rare with only isolated case reports in the pediatric literature. We present the case of a 2-year old boy who presented with a large abdominal mass and constipation. Pathologic diagnosis of the tumor was extrarenal Wilms tumor (ERWT) with favorable histology. We discuss the diagnostic workup, radiologic and operative findings, treatment and review of the literature.
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12
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Rare localization of extrarenal nephroblastoma in 1-month-old female infant. J Pediatr Urol 2012; 8:e43-5. [PMID: 22465824 DOI: 10.1016/j.jpurol.2012.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 03/08/2012] [Indexed: 11/23/2022]
Abstract
Extrarenal occurrence of Wilms' tumor is exceptional and the diagnosis is almost always made after surgery. The exact mechanism whereby a Wilms' tumor occurs in extrarenal tissue is unknown. The tumor is most commonly located in the retroperitoneum or inguinal region. Localization in subcutaneous tissue is extremely rare. In this paper, the case of a 1-month-old female infant with an extrarenal Wilms' tumor located in the lumbosacral region is presented. Surgical excision is the treatment of choice, and the same general therapeutic rules should be followed as when the kidney is affected.
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