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van der Beek JN, Geller JI, de Krijger RR, Graf N, Pritchard-Jones K, Drost J, Verschuur AC, Murphy D, Ray S, Spreafico F, Dzhuma K, Littooij AS, Selle B, Tytgat GAM, van den Heuvel-Eibrink MM. Characteristics and Outcome of Children with Renal Cell Carcinoma: A Narrative Review. Cancers (Basel) 2020; 12:E1776. [PMID: 32635225 PMCID: PMC7407101 DOI: 10.3390/cancers12071776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022] Open
Abstract
Pediatric renal cell carcinoma (RCC) is a rare type of kidney cancer, most commonly occurring in teenagers and young adolescents. Few relatively large series of pediatric RCC have been reported. Knowledge of clinical characteristics, outcome and treatment strategies are often based on the more frequently occurring adult types of RCC. However, published pediatric data suggest that clinical, molecular and histological characteristics of pediatric RCC differ from adult RCC. This paper summarizes reported series consisting of ≥10 RCC pediatric patients in order to create an up-to-date overview of the clinical and histopathological characteristics, treatment and outcome of pediatric RCC patients.
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Affiliation(s)
- Justine N. van der Beek
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - James I. Geller
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (K.P.-J.); (K.D.)
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Oncode Institute, 3521 AL Utrecht, The Netherlands
| | - Arnauld C. Verschuur
- Department of Pediatric Oncology, Hôpital d’Enfants de la Timone, APHM, 13005 Marseille, France;
| | - Dermot Murphy
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow G51 4TF, Scotland; (D.M.); (S.R.)
| | - Satyajit Ray
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow G51 4TF, Scotland; (D.M.); (S.R.)
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Kristina Dzhuma
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (K.P.-J.); (K.D.)
| | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Barbara Selle
- Department of Pediatric Hematology and Oncology, St. Annastift Children’s Hospital, 67065 Ludwigshafen, Germany;
| | - Godelieve A. M. Tytgat
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
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Young EE, Brown CT, Merguerian PA, Akhavan A. Pediatric and adolescent renal cell carcinoma. Urol Oncol 2016; 34:42-9. [DOI: 10.1016/j.urolonc.2015.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 12/13/2022]
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3
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Fedhila Ben Ayed F, Rhayem S, Doghri R, Ben Hassine L, Khemiri M, Mrad K, Bellagha I, Barsaoui S. [Secondary TFE3-associated renal cell carcinoma in a child treated for Ewing sarcoma]. Arch Pediatr 2015; 23:171-5. [PMID: 26702489 DOI: 10.1016/j.arcped.2015.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 08/12/2015] [Accepted: 11/09/2015] [Indexed: 11/30/2022]
Abstract
Renal cell carcinoma is a rare pediatric malignant tumor of the kidney. Unlike Wilms tumor, the efficacy of chemotherapy and radiation therapy in pediatric renal cell carcinoma remains uncertain. Surgery is the best treatment and prognosis is favorable when the tumor is localized and completely eradicated. We report an exceptional observation in a 7-year-old girl with renal cell carcinoma who had been treated 20 months previously for Ewing sarcoma with chemotherapy and radiotherapy. The renal tumor was revealed by abdominal pain without hematuria. She underwent a radical nephrectomy, and histopathology concluded in renal carcinoma associated with translocation Xp 11.2 grade 3 of Furhrman pT3a N1. No adjuvant therapy was given. After 3 years of follow-up, there is no evidence of local or metastatic recurrence. This observation is significant given the very young age of this patient, the occurrence after Ewing sarcoma with a short disease-free interval. It seems that translocation renal cell carcinoma is associated with previous exposure to chemotherapy, particularly topoisomerase II inhibitors or alkylating agents.
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Affiliation(s)
- F Fedhila Ben Ayed
- Service de médecine infantile A, hôpital d'enfants de Tunis, Bechir Hamza, Bab Saadoun place, 1007 Tunis Jabbari, Tunisie.
| | - S Rhayem
- Service de médecine infantile A, hôpital d'enfants de Tunis, Bechir Hamza, Bab Saadoun place, 1007 Tunis Jabbari, Tunisie
| | - R Doghri
- Service d'anatomopathologie, institut Salah Azaiz, Tunis, Tunisie
| | - L Ben Hassine
- Service de radiologie pédiatrique, hôpital d'enfants de Tunis, Tunis, Tunisie
| | - M Khemiri
- Service de médecine infantile A, hôpital d'enfants de Tunis, Bechir Hamza, Bab Saadoun place, 1007 Tunis Jabbari, Tunisie
| | - K Mrad
- Service d'anatomopathologie, institut Salah Azaiz, Tunis, Tunisie
| | - I Bellagha
- Service de radiologie pédiatrique, hôpital d'enfants de Tunis, Tunis, Tunisie
| | - S Barsaoui
- Service de médecine infantile A, hôpital d'enfants de Tunis, Bechir Hamza, Bab Saadoun place, 1007 Tunis Jabbari, Tunisie
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Cross BM, Breitwieser GE, Reinhardt TA, Rao R. Cellular calcium dynamics in lactation and breast cancer: from physiology to pathology. Am J Physiol Cell Physiol 2013; 306:C515-26. [PMID: 24225884 DOI: 10.1152/ajpcell.00330.2013] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Breast cancer is the second leading cause of cancer mortality in women, estimated at nearly 40,000 deaths and more than 230,000 new cases diagnosed in the U.S. this year alone. One of the defining characteristics of breast cancer is the radiographic presence of microcalcifications. These palpable mineral precipitates are commonly found in the breast after formation of a tumor. Since free Ca(2+) plays a crucial role as a second messenger inside cells, we hypothesize that these chelated precipitates may be a result of dysregulated Ca(2+) secretion associated with tumorigenesis. Transient and sustained elevations of intracellular Ca(2+) regulate cell proliferation, apoptosis and cell migration, and offer numerous therapeutic possibilities in controlling tumor growth and metastasis. During lactation, a developmentally determined program of gene expression controls the massive transcellular mobilization of Ca(2+) from the blood into milk by the coordinated action of calcium transporters, including pumps, channels, sensors and buffers, in a functional module that we term CALTRANS. Here we assess the evidence implicating genes that regulate free and buffered Ca(2+) in normal breast epithelium and cancer cells and discuss mechanisms that are likely to contribute to the pathological characteristics of breast cancer.
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Affiliation(s)
- Brandie M Cross
- Department of Physiology, The Johns Hopkins University, Baltimore, Maryland
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5
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Fall B, Diao B, Sow Y, Sarr A, Fall PA, Ndoye AK, Diagne BA. [Renal cell carcinoma in children: Report of a case with lymph node involvement]. Arch Pediatr 2011; 18:537-9. [PMID: 21458970 DOI: 10.1016/j.arcped.2011.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 03/19/2010] [Accepted: 02/15/2011] [Indexed: 10/28/2022]
Abstract
Renal cell carcinoma (RCC) in children is rare. This entity has different clinical and biological presentation characteristics from adult RCC. In contrast to Wilms tumor, the efficacy of chemotherapy and radiation therapy in pediatric RCC remains uncertain. Debate continues on the importance of lymph node dissection. The authors present a case of RCC with lymph node involvement in a 12-year-old boy. The treatment was radical nephrectomy and a limited lymphadenectomy. No adjuvant therapy was given. After 13 months of follow-up, there is no evidence of recurrence. This case shows that lymph node involvement (in the absence of distant metastases) is not associated with a poor prognosis in pediatric RCC and that lymphadenectomy in lymph node-positive cases is important.
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Affiliation(s)
- B Fall
- Service d'urologie-andrologie, CHU Aristide-Le-Dantec, avenue Pasteur, BP 35354 Dakar colobane, Sénégal
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6
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Helmy T, Sarhan O, Sarhan M, El-Baz M, Dawaba M, Ghali A. Renal cell carcinoma in children: single-center experience. J Pediatr Surg 2009; 44:1750-3. [PMID: 19735820 DOI: 10.1016/j.jpedsurg.2009.02.073] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 02/13/2009] [Accepted: 02/13/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of the study was to report the experience with renal cell carcinoma (RCC) in children. MATERIALS AND METHODS We conducted a retrospective study on renal adenocarcinoma cases treated in our center between 1993 and 2008. The age limit was established at 15 years. We collected data on personal history, diagnostic age, sex, clinical presentation, tumor laterality, diagnostic procedure, and tumor stage according to TNM classification proposed by the International Union Against Cancer (2002), surgical technique, pathologic subtype, and outcome. RESULTS Six children were included in this study (4 girls and 2 boys) with a mean age of 9.5 years (range, 4-14 years). Tumor affected the right side in 4 patients and the left side in 2. Follow-up ranged from 9 to 140 months (mean, 85). Two patients were diagnosed as stage T1aN0M0, another was T1bN2M0, and 2 were T2N0M0, whereas the last one was T3N2M0. Radical nephrectomy was performed in 5 patients, whereas partial nephrectomy was adopted in one patient. The most common histologic subtype was translocation morphology RCC. One patient had local recurrence, whereas the other 5 are currently disease-free. CONCLUSION Renal cell carcinoma is a rare histologic type of tumor in children, with certain features that differ from those in adults. In general, RCC in children tends to present later than Wilms' tumor and is usually associated with signs and/or symptoms of disease. In localized cases, the treatment of choice is radical nephrectomy.
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Affiliation(s)
- Tamer Helmy
- Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
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7
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Silberstein J, Grabowski J, Saltzstein SL, Kane CJ. Renal cell carcinoma in the pediatric population: Results from the California Cancer Registry. Pediatr Blood Cancer 2009; 52:237-41. [PMID: 18937317 DOI: 10.1002/pbc.21779] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Renal cell carcinoma (RCC) is a rare disease in children and adolescents. This study aimed to review epidemiologic characteristics and survival for pediatric RCC patients using a large, population-based database. PROCEDURE The California Cancer Registry (CCR) was reviewed from 1988 to 2004. All cases of RCC in patients younger than 21 years were identified and annual age-adjusted incidence rates were determined for the overall population and subdivided by ethnicity. Tumors were classified by stage and grade, and actuarial mortality rates were calculated. RESULTS From 1988 to 2004, 43 cases of RCC were identified in patients younger than 21 years, accounting for 4.3% of all renal tumors in this age group. The overall annual age-adjusted incidence was 0.01/100,000 with the tumor more common in non-Hispanic blacks (0.03/100,000) compared to non-Hispanic whites (0.01/100,000), Hispanics (<0.01/100,000), and non-Hispanic Asians/Pacific Islanders (<0.01/100,000). The mean age at presentation was 15.4 years (SD 4.03, SE 0.615). RCC was identified more frequently in females (58.14%). At the time of presentation, 53.49% of tumors were localized, 20.93% were regionally advanced, and 25.58% were metastatic. The observed actuarial survival at 5 and 10 years was 61% (+/-15.7%). CONCLUSION Pediatric RCC is an uncommon and aggressive tumor that occurs most frequently in children in the second decade of life, more often in females and blacks. The epidemiological characteristics of this tumor differ from adult RCC and Wilms tumor, suggesting its distinctive biology and potential need for alternative treatment strategies.
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Affiliation(s)
- Jonathan Silberstein
- Division of Urology, Department of Surgery, University of California, San Diego, Medical Center, San Diego, California, USA.
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8
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Epidemiology of kidney cancer. Adv Urol 2008:782381. [PMID: 19009036 PMCID: PMC2581742 DOI: 10.1155/2008/782381] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Revised: 08/20/2008] [Accepted: 09/26/2008] [Indexed: 11/18/2022] Open
Abstract
Some tumors are known to have a definite cause-effect etiology, but renal cell carcinoma (RCC) is not one of them precisely. With regard to RCC we can only try to identify some clinical and occupational factors as well as substances related to tumorigenesis. Smoking, chemical carcinogens like asbestos or organic solvents are some of these factors that increase the risk of the RCC. Viral infections and radiation therapy have also been described as risk factors. Some drugs can increase the incidence of RCC as well as other neoplasms. Of course, genetics plays an outstanding role in the development of some cases of kidney cancer. Chronic renal failure, hypertension, and dialysis need to be considered as special situations. Diet, obesity, lifestyle, and habits can also increase the risk of RCC. The aim of this review is to summarize the well-defined causes of renal cell carcinoma.
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9
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Pediatric renal adenocarcinoma: a review of our series. Urology 2008; 72:790-3. [PMID: 18502480 DOI: 10.1016/j.urology.2008.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Revised: 03/10/2008] [Accepted: 03/21/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To report our experience with pediatric renal adenocarcinoma. METHODS We conducted a retrospective review of renal adenocarcinoma cases from 1971 to 2006. RESULTS We treated 154 patients with renal tumor, 4 (2.6%) of whom had adenocarcinoma. The mean age of presentation was 8.5 years (range, 2-15 years). Three patients were female and 1 was male. The most common histologic subtype was clear cell carcinoma. Three patients were diagnosed as stage IIIB and one as stage II, according to Robson's classification. All patients were treated with radical nephroureterectomy. One patient died of disease and the other 3 are currently disease-free. CONCLUSIONS Adenocarcinoma is an uncommon histopathologic type of pediatric renal tumor. In patients with hematuria and abdominal or flank pain, we should consider this tumor as a possible diagnosis.
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Zugor V, Fridel S, Lausen B, Schott GE, Kühn R, Labanaris AP. Renal cell carcinoma under 35 years of age: comparison of survival rates for symptomatic and asymptomatic patients. Int Urol Nephrol 2007; 40:289-93. [PMID: 17899433 DOI: 10.1007/s11255-007-9274-y] [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: 07/05/2007] [Accepted: 08/13/2007] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Recent studies suggest that RCC detected in young adults is likely to be more symptomatic and potentially aggressive, since young patients are less likely to undergo radiologic examinations unless they have symptoms. The aim of this study is to identify the clinical, biological and histological entities of RCC in young patients, and to compare survival rates for symptomatic and asymptomatic patients. PATIENTS AND METHODS A review of 2,510 records of patients with RCC from 1965 to 2007 was conducted. Thirty-four patients under 35 years old were identified. The Kaplan-Meier system was used to calculate the cumulative survival rate at five and ten years post-surgery as well as the survival prognoses for patients who presented with symptoms and for patients for whom RCC was incidentally diagnosed. RESULTS The differences in cumulative survival rates at five and ten years between patients who presented with symptoms and patients whom RCC was incidentally diagnosed were not significant (P = 0.06). The Kaplan-Meier system used to calculate the cumulative survival rate at five and ten years postsurgery yielded survival rates of 79.4% at five years and 73.5% at ten years, respectively. DISCUSSION The biological and histological entities as well as the survival prognosis for RCC in young patients are similar to those for patients who present with RCC in the sixth and seventh decades of life. Additionally, young adults are likely to be more symptomatic, but the difference in survival between patients with symptoms and those without symptoms is not statistically significant.
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Affiliation(s)
- Vahudin Zugor
- Department of Urology, University of Erlangen Medical Center, Erlangen, Germany
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Ahmed HU, Arya M, Levitt G, Duffy PG, Sebire NJ, Mushtaq I. Part II: Treatment of primary malignant non-Wilms' renal tumours in children. Lancet Oncol 2007; 8:842-8. [PMID: 17765193 DOI: 10.1016/s1470-2045(07)70276-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Renal-cell carcinoma, clear-cell sarcoma, (congenital) mesoblastic nephroma, rhabdoid tumour, and renal medullary carcinoma form a heterogeneous group of childhood renal malignancies known as non-Wilms' tumours. Progress has been slow in improving the management of these tumours to decrease morbidity and increase survival. However, greater cooperation between national and international centres should engender specialisation, and an increased knowledge of the molecular biology of these tumours will inevitably lead to substantial progress over the next decade. This review is the second of two parts: the first part provided an updated review of the clinical presentation, imaging, and pathology of non-Wilms' tumours and this second part provides an updated review of the treatment of these tumours.
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Affiliation(s)
- Hashim Uddin Ahmed
- Institute of Urology and Nephrology, University College London Hospitals NHS Foundation Trust, London, UK.
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12
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Labanaris AP, Schott GE, Zugor V. Renal cell carcinoma in children under 10 years old: a presentation of four cases. Pediatr Surg Int 2007; 23:327-30. [PMID: 17333215 DOI: 10.1007/s00383-007-1879-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2007] [Indexed: 10/23/2022]
Abstract
Renal cell carcinoma (RCC) in childhood is a unique disease entity, representing only 2.3-6.6% of all renal tumors in children. Most experience with pediatric RCC is limited to case reports or case series consisting of relatively small numbers of cases. The aim of this study is to present four additional cases of this unique disease entity. The records of four patients presenting to our institution with renal cell carcinoma between 1986 and 2006 were examined. Only patients younger than 10 years were included. The clinical data included age, sex, signs and symptoms, surgery performed and clinical outcome. Data recorded from the pathology reports included tumor size, histologic subtype, grade (WHO), and stage (TNM). There were three boys and one girl aged between 11 months and 10 years at presentation. The classic triad of flank pain, gross hematuria and palpable abdominal mass were not encountered. A histopathological diagnosis of RCC was confirmed in all four cases without any positive lymph node involvement. Due to the increased detection of tumors with the use of imaging techniques such as ultrasound and computerized tomography, an increased number of incidentally diagnosed RCCs are found. The primary choice of the treatment of any stage of RCC is surgical excision. However, the preoperative diagnosis of tumor in children is difficult and the effects of chemotherapy, including immunotherapy, are unclear.
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Affiliation(s)
- Apostolos P Labanaris
- Department of Urology, Martha Maria Medical Center, Academic Hospital of Erlangen University, Nurnberg, Germany.
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13
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Estrada CR, Suthar AM, Eaton SH, Cilento BG. Renal cell carcinoma: Children's Hospital Boston experience. Urology 2006; 66:1296-300. [PMID: 16360460 DOI: 10.1016/j.urology.2005.06.104] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Revised: 05/25/2005] [Accepted: 06/22/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To review our experience to better define pediatric renal cell carcinoma (RCC). Pediatric RCC is rare, and recent data suggest it may be a unique disease. METHODS A retrospective review was conducted of hospital and pathology records from 1965 to 2003. Patients with RCC were identified, and the clinical and pathologic data were extracted. RESULTS Since 1965, 11 patients with RCC were treated, accounting for 3% of all renal tumors. In the first 20 years, 191 patients with renal tumor were treated, of whom 3 had RCC. In the most recent 15 years, 172 patients with renal tumor were treated, of whom 8 had RCC. The mean age at presentation was 14.7 years (range 9 to 17 years), with a female predominance (2.7:1). The clinical signs and symptoms included hematuria in 36%, flank pain in 27%, and an abdominal mass in 9%; 36% were discovered incidentally. Of the 11 RCC tumors, 45% were papillary and 55% were clear cell carcinoma. Papillary tumors presented at a worse stage and displayed more aggressive clinical behavior. Of 10 patients with available follow-up data, 6 had no evidence of RCC, 1 had died of other causes, 2 had died of metastatic RCC, and 1 was alive with recurrent RCC at a mean follow-up of 4.9 years. CONCLUSIONS The clinical presentation, pathologic characteristics, and clinical behavior of pediatric RCC are different than those for adult RCC. A possible increasing incidence of RCC in children would parallel an increased incidence in adults. Our findings warrant additional and coordinated efforts to better characterize RCC in children.
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Affiliation(s)
- Carlos R Estrada
- Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA.
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14
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Ismail-Zade RS, Zhavrid EA, Potapnev MP. Whole body hyperthermia in adjuvant therapy of children with renal cell carcinoma. Pediatr Blood Cancer 2005; 44:679-81. [PMID: 15700247 DOI: 10.1002/pbc.20299] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Whole body hyperthermia (WBH) in combination with chemotherapy has been proven to be effective in some patients with advanced malignancies. However, only limited experience exists regarding the application of WBH with chemotherapy in children. We present the results of applying WBH and chemotherapy in five children with advanced renal cell carcinoma (RCC). WBH (3 hr, 41.8-42.5 degrees C) combined with doxorubicin (50 mg/m2) and interferon-alpha (3 MU/m2) were applied to patients after nephrectomy and lymph node dissection. Each patient received three to eight courses of treatment three times weekly. All children tolerated the combined therapy well without complications. Follow-up of 7-68 months (median: 22 months) showed no tumor progression in patients with locoregional (n = 3) and metastatic (n = 2) disease. WBH with moderate dose doxorubicin and INF-alpha might be a feasible treatment option in childhood RCC.
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Affiliation(s)
- Reiman S Ismail-Zade
- Belarusian Center for Pediatric Oncology and Haemotology, Minsk, Republic of Belarus.
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15
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Abstract
Renal cell carcinoma arising from epithelial cells of the renal tubule is a highly aggressive and malignant tumor in all ages. Less than 2% of cases occur in childhood, relatively in older age group. Only a few pediatric series have been presented in the English literature. Tumor is presented with characteristic findings of flank pain, gross hematuria, and palpable mass. Although one half of the patients have metastasis at the time of diagnosis, most cases are currently being incidentally detected using improved imaging techniques. The overall prognosis in children appears to be similar to that in adults. Tumor stage and complete surgical resection have been reported as the most meaningful prognostic factors for the outcome. The incidence of metastatic disease is same as in adults. The effect of chemotherapy and immunotherapy, either preoperatively or postoperatively, is unclear. Cure is the most likely consequence in localized and completely resected tumors. Here, we present an 8-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no therapy.
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Affiliation(s)
- Ibrahim Otgün
- Department of Pediatric Surgery, Baskent University Faculty of Medicine, 06490 Bahçelievler Ankara, Turkey
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Fujimura K, Nishida M, Son A, Kunishima F, Segami N, Iizuka T, Kitaichi M. Heterotopic calcification in advanced cervical lymph nodes with metastasis from squamous cell carcinoma of the tongue: report of two cases. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ooe.2004.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Geller JI, Dome JS. Local lymph node involvement does not predict poor outcome in pediatric renal cell carcinoma. Cancer 2004; 101:1575-83. [PMID: 15378495 DOI: 10.1002/cncr.20548] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Local lymph node involvement in adults with renal cell carcinoma (RCC) is associated with poor outcome. The prognostic significance of local lymph node involvement in children with RCC has not been studied systematically. METHODS A retrospective review of patients treated at St Jude Children's Research Hospital (Memphis, TN) and an extensive review of the medical literature were undertaken to evaluate the prognostic significance of local lymph node involvement in pediatric RCC. RESULTS Thirteen patients with the diagnosis of RCC were treated at St. Jude since the hospital's inception in 1962. Four patients presented with lymph node-positive, distant metastasis-negative (N + M0) disease, and all 4 remain disease free after resection without adjuvant therapy (follow-up duration, 2-9 years). A systematic review of the literature including 243 pediatric patients with RCC revealed stage-specific survival rates of 92.5%, 84.6%, 72.7%, and 12.7% for Stage I-IV disease, respectively. Of 58 children with N + M0 RCC for whom outcome data were available, 42 (72.4%) were alive without disease at last follow-up. Among patients whose therapy could be discerned, those who received no adjuvant therapy fared as well (15 of 16 alive) as those who received various adjuvant treatments (22 of 31 alive). CONCLUSIONS Children with lymph node-positive RCC in the absence of distant metastatic disease had a relatively favorable long-term prognosis, with survival rate nearly triple those of adult historical controls. Until highly effective therapies for RCC are identified, these children should not be exposed to adjuvant treatment. Further investigation of the biologic differences between adult and pediatric RCC is warranted.
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Affiliation(s)
- James I Geller
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA
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19
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Adachi T, Nakatani T, Minami H, Ikemoto S, Esaki K, Morimoto H, Takase T. Renal cell carcinoma with hemorrhagic cyst formation in a 4-year-old boy. Int J Urol 2003; 10:267-70. [PMID: 12694467 DOI: 10.1046/j.1442-2042.2003.00616.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report on a case of renal cell carcinoma (RCC) with hemorrhagic cyst formation in a 4-year-old boy. The patient presented with asymptomatic macrohematuria. Abdominal ultrasound, computed tomography and magnetic resonance imaging demonstrated a left renal complicated cyst, 18 mm in diameter. Renal malignancy was suspected, and left radical nephrectomy was performed. Pathological diagnosis was a complicated cyst filled with bloody clots, with a wall composed of RCC. No metastases to the regional lymph nodes or other organs were found. This is an extremely rare occurrence of such a small RCC that developed a hemorrhagic cyst in a boy of this young age. The boy is being followed-up without any additional treatment.
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MESH Headings
- Adenocarcinoma, Clear Cell/diagnosis
- Adenocarcinoma, Clear Cell/surgery
- Adenocarcinoma, Papillary/diagnosis
- Adenocarcinoma, Papillary/surgery
- Carcinoma, Renal Cell/complications
- Carcinoma, Renal Cell/diagnosis
- Carcinoma, Renal Cell/surgery
- Child, Preschool
- Hemorrhage/complications
- Humans
- Kidney Diseases, Cystic/diagnosis
- Kidney Diseases, Cystic/surgery
- Kidney Neoplasms/complications
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/surgery
- Male
- Nephrectomy
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Affiliation(s)
- Takahisa Adachi
- Department of Urology, Yao Municipal Hospital, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Abstract
The classification of renal cell neoplasms has been extensively studied in the last decade, and a standardized nomenclature adopted. Although this system is based on a combination of genetic, histological and immunohistological features, in most cases accurate classification can be based on histological features alone. This review summarizes the key features of the tumours included in this system, and then focuses on diagnostic difficulties that can arise when using this system, as well as reviewing several recently characterized tumours that are not yet included.
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Affiliation(s)
- A A Renshaw
- Department of Pathology, Baptist Hospital of Miami, Miami, FL 33176, USA
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Ramsden WH. Imaging in the diagnosis and staging of paediatric abdominal tumours. IMAGING 2001. [DOI: 10.1259/img.13.4.130262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Affiliation(s)
- T Humpl
- Department of Paediatrics and Urology, University of Mainz, Mainz, Germany
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Uchiyama M, Iwafuchi M, Yagi M, Iinuma Y, Ohtaki M, Tomita Y, Hirota M, Kataoka S, Asami K. Treatment of childhood renal cell carcinoma with lymph node metastasis: two cases and a review of literature. J Surg Oncol 2000; 75:266-9. [PMID: 11135269 DOI: 10.1002/1096-9098(200012)75:4<266::aid-jso8>3.0.co;2-h] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Standard treatment for renal cell carcinoma (RCC) is radical nephrectomy with lymph node dissection. Stages I and II have encouraging prognoses, but Stage III with regional lymph node metastasis can be unfavorable. Adjuvant therapy for pediatric patients with advanced RCC with lymph node involvement or metastatic lesion has not been defined. Advanced pediatric RCC is reported in two patients (boys, aged 6 and 9 years: Stage IIIs, Robson; Stage III and IV, pTNM classification) treated by nephrectomy and lymph node dissection followed by postoperative interferon-alpha (IFN), that can be used as an adjuvant therapy with side effects such as fever, bone marrow suppression, or decreased liver function. One is doing well for 7 years, another is suffered from lung metastases at 3 years after surgery. Although immunotherapy is expected to improve survival in pediatric patients with advanced RCC, surgical resection of renal and metastatic tumors remains the standard treatment.
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Affiliation(s)
- M Uchiyama
- Department of Pediatric Surgery, Niigata University School of Medicine, Niigata, Japan.
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