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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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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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Kousik V, Vaswani BA, Milap M, Ram S. 18Fluorine-fluorodeoxyglucose PET-CT findings in a case of rarely seen metastatic adult extrarenal Wilms' tumor of retroperitoneum presenting as lower limb edema. World J Nucl Med 2021; 20:386-388. [PMID: 35018157 PMCID: PMC8686739 DOI: 10.4103/wjnm.wjnm_53_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 11/15/2022] Open
Abstract
Wilms’ tumor also called as nephroblastoma is commonly seen extracranial solid tumor involving kidneys in children. Rarely, Wilms’ tumor can arise from ectopic nephrogenic remnants located outside the kidneys. Extrarenal Wilms’ tumor comprises 3% of total Wilms’ tumor with its incidence even less common in adults. We report the staging and restaging fluorodeoxyglucose positron emission tomography-computed tomography findings in a case of locally advanced metastatic extrarenal adult Wilms’ tumor involving the retroperitoneum.
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Affiliation(s)
- Vankadari Kousik
- Department of Nuclear Medicine, Yashoda Hospital, Secunderabad, Telangana, India
| | - Bharat A Vaswani
- Department of Oncology, Yashoda Hospital, Secunderabad, Telangana, India
| | - Milap Milap
- Department of Pathology, Yashoda Hospital, Secunderabad, Telangana, India
| | - Sai Ram
- Department of Nuclear Medicine, Yashoda Hospital, Secunderabad, Telangana, India
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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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Apellaniz‐Ruiz M, Cullinan N, Grant R, Marrano P, Priest JR, Thorner PS, Goudie C, Foulkes WD. DICER1 screening in 15 paediatric paratesticular sarcomas unveils an unusual DICER1-associated sarcoma. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2020; 6:185-194. [PMID: 32222066 PMCID: PMC7339209 DOI: 10.1002/cjp2.164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
Individuals with DICER1 syndrome, a genetic disorder caused by pathogenic germline variants in DICER1, are at increased risk of developing a wide array of predominantly childhood onset conditions, including genitourinary sarcomas. However, data on DICER1 involvement in paratesticular sarcomas have not been published. Herein, we analyse a series of 15 paediatric paratesticular sarcomas and describe in detail the case of a male infant with a paratesticular myxoid tumour, considered to be a low‐grade sarcoma, who also manifested a cystic nephroma, a classic DICER1 syndrome phenotype. He harboured a pathogenic germline DICER1 variant and different somatic hot‐spot mutations in each tumour. The paratesticular tumour showed strong and diffuse expression for WT1 and CD10, an unusual immunophenotype in paediatric sarcomas, but typical of tumours of Müllerian origin. The tumour was postulated to arise from the appendix testis, a Müllerian remnant located in the paratestis. Such an origin would be analogous to other DICER1‐associated non‐epithelial gynaecological tumours, thought to arise from Müllerian derivatives. These findings point towards a key role of DICER1 in Müllerian‐derived structures. Supporting this hypothesis is the fact that the other paratesticular sarcomas from the series were either negative or focally positive for WT1 and for CD10, and none had any DICER1 mutations. In summary, we present the first case of a paratesticular sarcoma associated with DICER1 syndrome, emphasising that paratesticular tumours with an unusual histological appearance may suggest an underlying DICER1 mutation, especially in the presence of a personal or family history of DICER1‐associated disease. In this context, DICER1 mutation testing could lead to changes in clinical care including implementation of cancer care surveillance strategies.
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Affiliation(s)
- Maria Apellaniz‐Ruiz
- Department of Human GeneticsMcGill UniversityMontréalCanada
- Lady Davis Institute, Segal Cancer CentreJewish General Hospital, McGill UniversityMontréalCanada
| | - Noelle Cullinan
- Division of Hematology‐Oncology, The Hospital for Sick Children, and Department of PediatricsUniversity of TorontoTorontoCanada
| | - Ronald Grant
- Division of Hematology‐Oncology, The Hospital for Sick Children, and Department of PediatricsUniversity of TorontoTorontoCanada
| | - Paula Marrano
- Division of PathologyThe Hospital for Sick ChildrenTorontoCanada
| | | | - Paul S Thorner
- Division of PathologyThe Hospital for Sick ChildrenTorontoCanada
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
| | - Catherine Goudie
- Division of Hematology‐Oncology, Montréal Children's Hospital, Department of PediatricsMcGill UniversityMontréalCanada
| | - William D Foulkes
- Department of Human GeneticsMcGill UniversityMontréalCanada
- Lady Davis Institute, Segal Cancer CentreJewish General Hospital, McGill UniversityMontréalCanada
- Program in Cancer Genetics, Department of Oncology and Human GeneticsMcGill UniversityMontréalCanada
- Department of Medical GeneticsResearch Institute of the McGill University Health CentreMontréalCanada
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6
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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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7
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Extrarenal Nephroblastoma of the Retroperitoneal Space in Children: A Case Report and Review of the Literature. J Pediatr Hematol Oncol 2017; 39:296-298. [PMID: 27571127 DOI: 10.1097/mph.0000000000000674] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Extrarenal nephroblastoma (ERNB) is a rare disease. We report a case of ERNB in a 4-year-old boy complaining of abdominal pain and vomiting. Imaging showed a retroperitoneal mass and left hydronephrosis. The mass was completely removed by surgery. The pathologic diagnosis was ERNB with favorable histology. Postoperative chemotherapy was administered for 24 weeks with actinomycin D, vincristine, and doxorubicin. No signs of recurrence were found for the next 3 years. We consider 53 reports of ERNB and our own. Median age at diagnosis was 42 months. The most common site is the retroperitoneal space (44.4%), followed by the uterus (14.8%).
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8
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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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9
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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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10
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Manuel N, Ricardo P, Pilar GP, Miguel RM. Perspectives in Pediatric Pathology, Chapter 12. Congenital Epididymal Anomalies. Pediatr Dev Pathol 2016; 19:12-23. [PMID: 25119979 DOI: 10.2350/14-04-1473-pb.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Nistal Manuel
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Paniagua Ricardo
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - González-Peramato Pilar
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Reyes-Múgica Miguel
- 3 Department of Pathology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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Yang YJ, Xiang B, Liu JX, Yang M, Chen HZ. Ultrasound in diagnosis of intrascrotal metastasis of Wilms' tumor: first case report of a Chinese boy and review of the literature. J Med Ultrason (2001) 2015; 42:575-8. [PMID: 26576985 DOI: 10.1007/s10396-015-0642-4] [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: 01/26/2015] [Accepted: 05/12/2015] [Indexed: 02/05/2023]
Abstract
A 31-month-old boy with Wilms' tumor (WT), which primarily had originated from the left kidney, was treated with nephrectomy and adjuvant chemotherapy. 2 months after nephrectomy, a left scrotal mass was found at routine follow-up. High-frequency sonography examination revealed an enlarged left testis with a heterogeneous texture and a hypoechoic solid mass in the left scrotum. Moreover, hypervascular signals presented in both the left testis and the mass on color Doppler flow imaging. Left orchiectomy was performed for suspected intrascrotal metastasis of WT, which was confirmed by histopathology examination. This was the first case of intrascrotal metastasis of WT reported in China with a detailed ultrasound description. Meanwhile, this study also reviewed the comparable diagnostic methods of intrascrotal metastasis of WT found in the English literature.
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Affiliation(s)
- Yu-Jia Yang
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China
| | - Bo Xiang
- Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ju-Xian Liu
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
| | - Mei Yang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hui-Zhu Chen
- Department of Radiology, West China Second Hospital, Sichuan University, Chengdu, China
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12
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Nistal M, Paniagua R, González-Peramato P, Reyes-Múgica M. Perspectives in Pediatric Pathology, Chapter 10. Ectopic and Heterotopic Tissues in the Testis. Pediatr Dev Pathol 2015; 18:446-57. [PMID: 25105225 DOI: 10.2350/14-04-1469-pb.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Manuel Nistal
- 1 Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcalá, Madrid, Spain
| | - Pilar González-Peramato
- 1 Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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13
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Apoznański W, Sawicz-Birkowska K, Palczewski M, Szydełko T. Extrarenal nephroblastoma. Cent European J Urol 2015; 68:153-6. [PMID: 26251733 PMCID: PMC4526617 DOI: 10.5173/ceju.2015.571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 04/06/2015] [Accepted: 04/17/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction Nephroblastoma is one of the most common solid tumours in children. The occurrence of extrarenal nephroblastoma is exceedingly rare. What can be defined as extrarenal Wilms’ tumor must satisfy the following criteria: histologically confirmed nephroblastoma and extrarenal location. Material and methods Current data on extrarenal nephroblastoma based on a selective review of the literature. Results The retroperineal location is reported to be typical in males, whereas the inguinal region is believed to predominate in females. There are no characteristic manifestations of extrarenal nephroblastoma. The symptoms depend on the location and stage upon diagnosis. US, CT and MRI are used to detect tumours in the retroperiteneal space, inguinal, sacro-coccal and scrotal area. However, extrarenal nephroblastoma does not show characteristic radiological features. Conclusions In absence of typical clinical presentation or conclusive imaging tests, the diagnosis is based on histology after the resection of the tumor. The recommended management of the extrarenal nephroblastoma is similar to the treatment of intrarenal nephroblastoma.
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Affiliation(s)
- Wojciech Apoznański
- Department of Pediatric Surgery and Urology, Medical University, Wrocław, Poland
| | | | - Mateusz Palczewski
- Department of Pediatric Surgery and Urology, Medical University, Wrocław, Poland
| | - Tomasz Szydełko
- Clinical Department of Urology, 4th Clinical Military Hospital, Department of Palliative Care Nursing, University of Medicine, Wrocław, Poland
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Morandi A, Fagnani AM, Runza L, Farris G, Zanini A, Parolini F, Bassi G, Gentilino V, Macchini F, Arnoldi R, Leva E. Extrarenal testicular Wilms' tumor in a 3-year-old child. Pediatr Surg Int 2013; 29:961-4. [PMID: 23794024 DOI: 10.1007/s00383-013-3338-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2013] [Indexed: 11/29/2022]
Abstract
We report an extremely rare case of extrarenal testicular Wilms' tumor in a 3-year-old boy with intrabdominal undescended left testis. The patient was admitted because of pain and vomiting, with evidence of a huge abdominal mass. At surgery a large tumor arising from the intrabdominal testis was found. Histology showed the classical triphasic Wilms' tumor elements: epithelial, mesenchymal and blastemal areas. Extrarenal Wilms' tumors account for only 3% of all Wilms' tumors and just -100 cases have been reported in literature. Testicular origin is anecdotic. We present histomorphological, histogenetic, clinical, diagnostic, prognostic and therapeutic features of this rare tumor.
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Affiliation(s)
- A Morandi
- Department of Pediatric Surgery, FONDAZIONE IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122 Milano, Italy.
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15
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Steelman CK, Bannister LL, Palmer M, Chang TS, Elawabdeh N, Shehata BM. Nephrogenic rest within a lipomyelomeningocele in a patient with unilateral renal agenesis. Fetal Pediatr Pathol 2012; 31:260-4. [PMID: 22432683 DOI: 10.3109/15513815.2012.659377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Nephrogenic rests (NR) are foci of embryonal renal tissue that persist beyond the normal period of renal morphogenesis. They are commonly found in kidneys bearing Wilms tumor but may also rarely occur in different locations. Nephrogenic rests have been reported in the lumbosacral area in a total of nine cases, including our case. Of the nine cases, only one case prior to ours showed agenesis of one kidney in association with the NR. We report a 2-year-old female with a lipomyelomeningocele containing NRs and agenesis of the right kidney and discuss the molecular genetic basis of lumbosacral NR.
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F-18 FDG PET/CT imaging of metastatic extrarenal Wilms tumor arising in the inguinal canal. Clin Nucl Med 2011; 36:475-8. [PMID: 21552031 DOI: 10.1097/rlu.0b013e31820ade92] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Extrarenal Wilms tumor (ERWT) is rare, and has been reported sporadically in the literatures. ERWT can arise anywhere from the renal bed to the testes; reported locations of ERWTs include the retroperitoneum, inguinal canal, endocervix, uterus, epididymis, and sigmoid mesocolon. We report the F-18 FDG PET/CT imaging findings of an ERWT arising from the inguinal canal in a 9-year-old boy. F-18 FDG accumulated in the metastatic lesions of the lung and mediastinal lymph nodes, as well as the primary ERWT. After chemotherapy, a follow-up PET/CT showed complete metabolic remission. F-18 FDG PET/CT is useful in detecting primary and metastatic ERWTs and in evaluating treatment response.
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Taguchi S, Shono T, Mori D, Horie H. Extrarenal Wilms tumor in children with unfavorable histology: a case report. J Pediatr Surg 2010; 45:e19-22. [PMID: 20850611 DOI: 10.1016/j.jpedsurg.2010.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 05/27/2010] [Accepted: 06/01/2010] [Indexed: 10/19/2022]
Abstract
Extrarenal Wilms tumor is extremely rare, and only 25 cases in children have been reported to date in Japan. A 2-year-old girl presented with a large left lower quadrant abdominal mass. Abdominal computed tomography revealed a retroperitoneal tumor located below the left kidney. At laparotomy, the tumor was encapsulated without evidence of metastasis to other abdominal organs. Pathologic diagnosis of the tumor was extrarenal Wilms tumor with diffuse anaplasia. After complete tumor resection, chemotherapy was administered according to the treatment protocol (Regimen I) of the Japan Wilms Tumor Study Group. Cyclophosphamide and etoposide were administered in combination with vincristine and doxorubicin. Two years after treatment, the patient has had no evidence of recurrence.
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Affiliation(s)
- Shohei Taguchi
- Department of Pediatric Surgery, Saga Prefectural Hospital KOSEIKASN, Saga, Japan.
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Presacral Extrarenal Wilms Tumor in a Child. Urology 2009; 74:308-10. [DOI: 10.1016/j.urology.2009.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 12/31/2008] [Accepted: 01/04/2009] [Indexed: 11/19/2022]
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Abstract
BACKGROUND/PURPOSE This study aimed to illustrate the first report of extrarenal Wilms tumor occurring in a family. MATERIALS AND METHODS Retrospective case note review of 3 siblings, 2 of which presented with extrarenal Wilms tumor. Immunohistochemical analysis for WT1 gene product was performed together with molecular genetic linkage studies. RESULTS A 3-year-old boy had excision of a right-sided extrarenal retroperitoneal Wilms tumor and nephrectomy followed by chemotherapy. At follow-up of 4 years, the boy was well and thriving. Aged 2 years, his sister developed a left-sided retroperitoneal extrarenal Wilms tumor. She had a tumor excision and nephrectomy followed by chemotherapy. She was well on follow-up more than a year after completion of treatment. Immunohistochemical analysis identified WT1 gene product within the tumor for both cases. Molecular genetic linkage studies showed no linkage between the index cases at FWT1 locus. Although possible linkage was demonstrated at WT1 locus, no mutation was found in the coding sequence and intron/exon boundaries of WT1 gene in index patient 1. A possible linkage between the index cases was also found at FWT2 locus. This could be a chance event because of the close relationship of the 2 patients. CONCLUSIONS We could identify extrarenal Wilms tumor in a family for the first time. Immunohistochemical analysis showed WT1 gene products in both cases. Linkage studies for Wilms tumor genes within the family were inconclusive. The possible linkage between the 2 index cases may be a chance event.
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Vanasupa BP, Aaberg RA, Sutherland RS. Testicular Teratoma with Nephroblastoma Component. Urology 2007; 70:179.e1-2. [PMID: 17656239 DOI: 10.1016/j.urology.2007.03.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2006] [Revised: 02/25/2007] [Accepted: 03/20/2007] [Indexed: 10/23/2022]
Abstract
We report the development of Wilms' tumor in an atrophic testis and review the potential molecular pathogenesis. An 18-year-old man presented with 2 days of right testicular pain and growth in his atrophic testis. Ultrasonography revealed a heterogeneous mass. The chest radiographic findings and testicular tumor marker levels were normal. He underwent radical orchiectomy, with the pathologic examination showing teratoma with a nephroblastoma component, focal embryonal carcinoma, and minute yolk sac tumor. The development of Wilms' tumor in the testis is rare and can be explained by the activation of the WT1 gene during embryogenesis.
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Affiliation(s)
- Bill P Vanasupa
- Department of Surgery, Urology Service, Tripler Army Medical Center, Honolulu, Hawaii 96859-5000, USA.
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Sastri J, Dedhia R, Laskar S, Shet T, Kurkure P, Muckaden M. Extra-renal Wilms' tumour--is it different? Pediatr Nephrol 2006; 21:591-6. [PMID: 16520955 DOI: 10.1007/s00467-005-0002-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2005] [Revised: 09/08/2005] [Accepted: 09/09/2005] [Indexed: 10/24/2022]
Abstract
Nephroblastomas (Wilms' tumour) are the most common solid malignancies in childhood, but extra-renal Wilms' tumours are rare entities, and the diagnosis is made only after surgical intervention. However, the embryogenesis and the exact mechanism of occurrence of primary ERWTs is controversial, thereby presenting a number of unanswered questions of great theoretical interests. We present three well-proven cases of extra-renal Wilms' tumour together with a review of the literature based on its histogenesis, its behaviour and its management policies.
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Affiliation(s)
- Jayant Sastri
- Radiation Oncology, Tata Memorial Hospital, Dr Ernest Borges Marg, Parel, Mumbai 400012, India
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Primary Extrarenal Nephrogenic Rest. J Urol 2002. [DOI: 10.1097/00005392-200210010-00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Stephen Bennett
- Division of Pediatric Surgery, Children's Hospital Medical Center, Cinncinati, Ohio, USA
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Shmushkevich A, Gofrit ON, Miskin H, Peylan-Ramu N, Schiller M. Isolated extrarenal papillary carcinoma in a child. J Pediatr Surg 2002; 37:664-5. [PMID: 11912533 DOI: 10.1053/jpsu.2002.31637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A previously healthy 12-year-old boy presented with a mass in the right retroperitoneum adjacent to an ipsilateral hypoplastic kidney. Complete resection of the tumor and kidney were done. The tumor was found to be papillary adenocarcinoma lying 3 cm apart from a contracted kidney, which was free of tumor. No adjuvant therapy was given. After 50 months of follow-up the child is healthy without evidence of tumor recurrence.
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Affiliation(s)
- Alex Shmushkevich
- Departments of Pediatric Surgery and Pediatrics, Hadassah University Hospital, Jerusalem, Israel
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Abstract
Five previous cases of extrarenal Wilms tumor (EWT) occurring in the uterus have been reported. The oldest patient was 22 years. We report a case of uterine EWT occurring in a 42-year-old woman. Histologically, there was typical triphasic differentiation, including epithelial, blastemal, and mesenchymal elements. The important differential diagnosis in this age group, the malignant mixed mullerian tumor, is excluded by the absence of glomeruloid structures and primitive tubules. The exact histogenesis of EWT is unknown but most likely relates to the presence of nephrogenic rests occurring in the female genital tract.
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Affiliation(s)
- R S Muc
- Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.
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Babin EA, Davis JR, Hatch KD, Hallum AV. Wilms' tumor of the cervix: a case report and review of the literature. Gynecol Oncol 2000; 76:107-11. [PMID: 10620450 DOI: 10.1006/gyno.1999.5625] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Extrarenal Wilms' tumors are rare, with only 55 well-documented cases in the literature and only 4 confined to the uterus. A fifth case along with review of the current literature is presented. CASE A 13-year-old girl presented with a 2-month history of irregular vaginal spotting. A 6.5 x 4.5 x 2.5-cm polypoid mass meeting criteria for an extrarenal Wilms tumor was removed from the superior aspect of the cervix, but recurred 8 months later on the posterior lip. The patient underwent a Schauta procedure, lymph node dissection, and bilateral oophoropexy. The surgery was followed by typical renal Wilms' tumor chemotherapy. The patient is without evidence of disease 5 years after surgery. DISCUSSION This case uniquely suggests that limited excision of the original tumor has inherent risks for relapse. Oophoropexy appears to be reasonable when fertility preservation is desired and reconfirms that treatment mimicking renal nephroblastomas offers good long-term survival.
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Affiliation(s)
- E A Babin
- Department of Obstetrics and Gynecology, University of Arizona Health Sciences Center, Tucson, Arizona
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