1
|
Bahlouli N, Harras YE, Chait F, Laasri K, Allali N, Chat L, Haddad SE. Spinal metastasis of nephroblastoma: Yes it exists. Radiol Case Rep 2024; 19:2545-2548. [PMID: 38596178 PMCID: PMC11001615 DOI: 10.1016/j.radcr.2024.02.103] [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: 01/23/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 04/11/2024] Open
Abstract
Nephroblastoma or Wilms' tumor is the most common malignant tumor of the kidney in the pediatric population. Metastasis is caused by hematogenous spread. The most common localizations in decreasing order of frequency are lymph nodes, lungs, and liver. The bone is very rarely affected. According to the literature, bone metastases have been described in the iliac bone, skull, and mandible. The vertebral localization was described in 3 cases only, the first 1 in 2009, and the 2 others in 2015 . The goal of our work is to report a very rare case of metastatic vertebral localization of a Wilms' tumor in relapse after treatment; and thus to underline the potential for vertebral and intracanal involvement in nephroblastoma.
Collapse
Affiliation(s)
- Nourrelhouda Bahlouli
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Yahya El Harras
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Fatima Chait
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Khadija Laasri
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Nazik Allali
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Latifa Chat
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| | - Siham El Haddad
- Pediatric Teaching Hospital, Radiology Department, Mohammed V University, Rabat, Morocco
| |
Collapse
|
2
|
Kim J, Kent MS, Théon AP, Lejeune AT, Hansen KS. Conventional fractionated radiotherapy outcomes for young dogs with nephroblastoma of the spinal cord: 5 cases. Vet Comp Oncol 2023; 21:419-426. [PMID: 37188527 DOI: 10.1111/vco.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
Published radiotherapy results for spinal nephroblastomas in dogs are limited. In this retrospective longitudinal study (1/2007-1/2022), five dogs with a median age of 2.8 years received post-operative 3D conformal, conventional fractionated radiotherapy (CFRT) with 2-4 fields (parallel-opposed with or without two hinge-angle fields), for an incompletely resected nephroblastoma. Clinical findings prior to surgery included one or more of the following: pelvic limb paresis (5), faecal incontinence (2), flaccid tail (1), non-ambulatory (2) and deep pain loss (1). All masses were located between T11 and L3 and surgically removed via hemilaminectomy. Dogs received 45-50 Gray (Gy) in 18-20 fractions, and no dogs received chemotherapy post-radiation. At analysis, all dogs were deceased, with none lost to follow-up. The median overall survival (OS) from first treatment to death of any cause was 3.4 years (1234 days; 95% CI 68 days-upper limit not reached; range: 68-3607 days). The median planning target volume was 51.3 cc, with a median PTV dose of 51.4 Gy and median D98 = 48.3 Gy. Late complications or recurrence was difficult to fully determine in this small dataset; however, some degree of ataxia persisted throughout life in all dogs. This study provides preliminary evidence that post-operative radiotherapy may result in prolonged survival times dogs with spinal nephroblastomas.
Collapse
Affiliation(s)
- Jaeyoung Kim
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Michael Sean Kent
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
| | - Alain Pierre Théon
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
| | - Amandine Tamara Lejeune
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
| | - Katherine Sarah Hansen
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
| |
Collapse
|
3
|
Suprarenal Wilms tumour with intraspinal metastases: An uncommon presentation of a common tumour. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2020. [DOI: 10.1016/j.phoj.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
4
|
Tagawa M, Shimbo G, Tomihari M, Yanagawa M, Watanabe KI, Horiuchi N, Kobayashi Y, Miyahara K. Intramedullary spinal nephroblastoma in a mixed breed dog. J Vet Med Sci 2020; 82:917-921. [PMID: 32418935 PMCID: PMC7399307 DOI: 10.1292/jvms.20-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 1-year-old male mixed breed dog presented for the evaluation of progressive hindlimb paresis. Neurological examination indicated a spinal cord lesion between the 3rd thoracic and 3rd lumbar vertebrae. Magnetic resonance imaging (MRI) revealed an intramedullary spinal cord lesion located at the level of the 1st and 2nd lumbar vertebrae. Following cytoreductive surgery of the mass, palliative radiation therapy was administered. A diagnosis of nephroblastoma was made based on histological examination. After radiation therapy, the disappearance of the spinal lesion was confirmed by MRI. The dog was improved from gait abnormality and alive at 16 months postoperatively, with slight signs of neurological dysfunction.
Collapse
Affiliation(s)
- Michihito Tagawa
- Veterinary Medical Center, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Genya Shimbo
- Veterinary Medical Center, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Mizuki Tomihari
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Masashi Yanagawa
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Ken-Ichi Watanabe
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Noriyuki Horiuchi
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Yoshiyasu Kobayashi
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - Kazuro Miyahara
- Veterinary Medical Center, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| |
Collapse
|
5
|
de la Monneraye Y, Michon J, Pacquement H, Aerts I, Orbach D, Doz F, Bourdeaut F, Sarnacki S, Philippe-Chomette P, Audry G, Coulomb A, Fréneaux P, Klijanienko J, Berrebi D, Zucker JM, Schleiermacher G, Brisse HJ. Indications and results of diagnostic biopsy in pediatric renal tumors: A retrospective analysis of 317 patients with critical review of SIOP guidelines. Pediatr Blood Cancer 2019; 66:e27641. [PMID: 30746839 DOI: 10.1002/pbc.27641] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES According to the Renal Tumor Study Group (RTSG) of the International Society of Paediatric Oncology (SIOP), diagnostic biopsy of renal tumors prior to neoadjuvant chemotherapy is not mandatory unless the presentation is atypical for a Wilms tumor (WT). This study addresses the relevance of this strategy as well as the accuracy and safety of image-guided needle biopsy. METHODS Clinical, radiological, and pathological data from 317 children (141 males/176 females, mean age: 4 years, range, 0-17.6) consecutively treated in one SIOP-affiliated institution were retrospectively analyzed. RESULTS Presumptive chemotherapy for WT was decided for 182 patients (57% of the cohort), 24 (8%) were operated upfront, and 111 (35%) were biopsied at diagnosis. A non-WT was confirmed after surgery in 5/182 (3%), 11/24 (46%), and 28/111 (25%), respectively. Age at diagnosis was the most commonly (46%) used criterion to go for biopsy but a nine-year threshold should be retrospectively considered more relevant. Tumor volumes of clear cell sarcoma of the kidney and WT were significantly higher than those of other tumors (P = 0.002). The agreement between core-needle biopsy (CNB) and final histology was 99%. No significant morbidity was associated with CNB. CONCLUSION The use of SIOP criteria to identify patients eligible for presumptive WT neoadjuvant chemotherapy or upfront surgery avoided biopsy in 65% of children and led to a 97% rate of appropriate preoperative chemotherapy. Image-guided CNB is a safe and accurate diagnostic procedure. The relevance of SIOP biopsy criteria might be improved by using an older age threshold (9 years instead of 6 years) and by adding initial tumor volume.
Collapse
Affiliation(s)
- Yvan de la Monneraye
- Department of Pediatrics, APHP, University Hospital Ambroise Paré, Boulogne-Billancourt, Paris, France.,Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - J Michon
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - H Pacquement
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - I Aerts
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - Daniel Orbach
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - F Doz
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France.,University Paris Descartes, Paris, France
| | - F Bourdeaut
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - S Sarnacki
- Department of Surgery, APHP, University Hospital Necker-Enfants-Malades, Paris, France
| | - P Philippe-Chomette
- Department of Surgery, APHP, University Hospital Robert Debré, Paris, France
| | - G Audry
- Department of Surgery, APHP, University Hospital Armand-Trousseau, Paris, France
| | - A Coulomb
- Department of Pathology, APHP, University Hospital Armand-Trousseau, Paris, France
| | - P Fréneaux
- Department of Biopathology, Institut Curie, Paris, France
| | - J Klijanienko
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - D Berrebi
- Department of Pathology, APHP, University Hospital Robert Debré, Paris, France.,University Paris Diderot, Paris, France
| | - J-M Zucker
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France
| | - G Schleiermacher
- Oncology Center SIREDO (Care, Innovation, Research for Cancer in Children, Adolescents and Young Adults), Institut Curie, Paris, France.,INSERM U830 Transfer Department, RTOP (Translational Research in Pediatric Oncology), Institut Curie, Paris, France
| | - H J Brisse
- Imaging Department, Institut Curie, Paris, France.,Paris Sciences et Lettres Research University, Paris, France
| |
Collapse
|
6
|
Iaboni DSM, Chi YY, Kim Y, Dome JS, Fernandez CV. Outcome of Wilms tumor patients with bone metastasis enrolled on National Wilms Tumor Studies 1-5: A report from the Children's Oncology Group. Pediatr Blood Cancer 2019; 66:e27430. [PMID: 30160355 PMCID: PMC6249096 DOI: 10.1002/pbc.27430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/19/2018] [Accepted: 08/09/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Wilms tumor (WT) is the most common renal tumor in children. We describe the outcomes for patients with WT that metastasized to bone (WTBM) to assist in decision making for these uncommon patients. PROCEDURE We retrospectively reviewed the research records of patients identified with WTBM from the National Wilms Tumor Study (NWTS 1-5) database. We then related overall survival (OS) to histology, chemotherapy, radiation therapy to bone, location of metastasis, and when bone metastasis presented. RESULTS Thirty-eight of 8609 patients enrolled on NWTS 1-5 (0.44%) developed bone metastasis. Bone metastasis most commonly first occurred at progression or relapse (29/38, 76%). Five of thirty-eight survived (13%) with the 5-year OS following presentation of bone metastasis of 14.3% (95% CI: 2.7-25.8%). The primary cause of death was tumor (29/33, 88%). Of those who died, the median survival time was 10.9 months (range 0.49-61.4). Four of nine (44%) patients presenting at diagnosis and 3% (1/29) of patients presenting in progression or relapse survived (P = 0.0075). Nineteen percent (5/26) of patients with favorable histology and 0% (0/12) with anaplastic histology survived (P = 0.16). Of the five survivors, median follow-up was 14 years (range 6.7-23.8). Radiation to metastatic bone sites was recorded in three of five survivors. No consistent chemotherapeutic approach appeared to be associated with disease outcome. CONCLUSION Bone metastasis is rare in patients with WT, occurring more commonly in progression or relapse than at initial diagnosis. Patients with WTBM have poor prognosis. We could not identify a consistent chemotherapeutic strategy associated with survival.
Collapse
Affiliation(s)
- Douglas S M Iaboni
- Faculty of Medicine, Dalhousie Medical School, Dalhousie University, Halifax, Canada
| | - Yueh-Yun Chi
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yeonil Kim
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | | | - Conrad V Fernandez
- Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Canada
| |
Collapse
|
7
|
A Wilms' Tumor with Spinal Cord Compression: An Extrarenal Origin? Case Rep Pediatr 2018; 2018:1709271. [PMID: 30254782 PMCID: PMC6140272 DOI: 10.1155/2018/1709271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/05/2018] [Indexed: 11/17/2022] Open
Abstract
Spinal cord compression in Wilms' tumor (WT) is an extremely rare event that can have a very poor prognosis if not taken care of rapidly. Most cases reported in the literature involve widely metastatic patient with bone or paraspinal metastases or occasionally intradural metastasis. Here, we present the case of a 3-year-old girl of WT confirmed by biopsy, with spinal cord compression due to the direct contiguous spread of a tumor through 2 vertebral foramina. Abdominal ultrasonography and magnetic resonance imaging performed for an abdominal mass revealed a large heterogeneous tumor near the upper pole of the left kidney. A nodular infiltration extended through the T11-L1 and L1-L2 neural foramina, forming an intraspinal mass that compressed the spinal cord. Major paresthesia subsequently occurred, requiring urgent treatment with corticosteroids and chemotherapy. The evolution was rapidly satisfying. After six courses of chemotherapy, a left nephrectomy was performed. Macroscopic examination identified a large tumor attached to the kidney without renal infiltration. Microscopical examination concluded to a nephroblastoma with regressive changes, of intermediate risk. Evolution at 6 months is satisfactory, with no neurological deficit. The histological aspect of the tumor and the clinical outcome suggest that she had an extrarenal WT that spread through the vertebral foramina and was secondarily attached to the kidney.
Collapse
|
8
|
McDuffie LA, Fallon RJ, Vik TA, Billmire DF. SUCCESSFUL TREATMENT OF A SOLITARY SKULL METASTASIS IN A CHILD WITH WILMS' TUMOR. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017; 22:47-49. [PMID: 29130032 DOI: 10.1016/j.epsc.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
This report presents the successful treatment of a child with a solitary metastatic lesion to the calvarium following treatment for Stage III anaplastic Wilms' Tumor.
Collapse
Affiliation(s)
- Lucas A McDuffie
- Thoracic and Gastrointestinal Oncology Branch and Immunotherapy Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, Maryland 20892
| | - Robert J Fallon
- Department of Pediatric Hematology/Oncology, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, Indiana 46202
| | - Terry A Vik
- Department of Pediatric Hematology/Oncology, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, Indiana 46202
| | - Deborah F Billmire
- Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, Indiana 46202
| |
Collapse
|
9
|
Parvin S, Ghosh R, Das RN, Saha K, Roy P, Datta C, Chatterjee U. Primary Renal Rhabdomyosarcoma: An Unusual Bone Metastasizing Tumor of Kidney. Fetal Pediatr Pathol 2016; 35:251-9. [PMID: 27182845 DOI: 10.1080/15513815.2016.1175528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Rhabdomyosarcoma (RMS) is one of the common malignant tumors in the pediatric age group. There is only a single case report of primary renal alveolar RMS. Fine needle aspiration (FNA) findings of primary renal RMS has not been reported so far. Hence we present an unusual case of primary alveolar RMS of the kidney. An 11 year old boy presented with an abdominal mass. On FNA a diagnosis of undifferentiated sarcoma and anaplastic Wilms tumor were considered. The tumor was resected and showed histopathological features of alveolar rhabdomyosarcoma. He developed multiple bony metastases and succumbed to the illness despite aggressive chemotherapy. RMS of the kidney should be considered in the differential diagnosis of children with a renal mass, and may have an aggressive clinical course with bone metastases.
Collapse
Affiliation(s)
- Shabnam Parvin
- a Department of Pathology , Institute of Post Graduate Medical Education and Research , Kolkata , India
| | - Ranajoy Ghosh
- a Department of Pathology , Institute of Post Graduate Medical Education and Research , Kolkata , India
| | - Ram Narayan Das
- a Department of Pathology , Institute of Post Graduate Medical Education and Research , Kolkata , India
| | - Koushik Saha
- b Department of Pediatric Surgery , NRS Medical College , Kolkata , India
| | - Paromita Roy
- c Department of Pathology , Tata Medical Centre , Kolkata , India
| | - Chhanda Datta
- a Department of Pathology , Institute of Post Graduate Medical Education and Research , Kolkata , India
| | - Uttara Chatterjee
- a Department of Pathology , Institute of Post Graduate Medical Education and Research , Kolkata , India
| |
Collapse
|
10
|
Abstract
Bone metastases and intraspinal spread are rare events in Wilms tumor. We report 2 cases of Wilms tumor with vertebral metastases associated with spinal cord compression; 1 case was reported during diagnosis and the other at relapse. Both children benefited from emergency surgical decompression followed by intensive multimodality therapy, resulting in long-term disease-free remission.
Collapse
|
11
|
|
12
|
Abstract
PURPOSE To document the clinical, imaging and histopathological features of five children with paraplegia due to Wilms' tumour (WT), highlighting therapeutic options and patient outcome in a developing country. METHODS Patients with WT and paraplegia seen at the Department of Paediatric Surgery since 1984 form the study cohort. Patient demographics, duration of neurological symptoms, stage of primary tumour, therapeutic intervention and outcome were recorded. Histology of the primary tumours and paraspinal or epidural biopsies were reviewed. RESULTS Five patients with WT and paraplegia were identified. Imaging showed epidural masses with paraspinal disease, cord displacement and compression. Four patients have died. Of the two patients with neurological recovery, one relapsed 4 months later. Histology revealed triphasic WT with one case showing anaplasia. Paraspinal or epidural biopsies confirmed WT with post-treatment changes. Three biopsies showed lymphovascular, perineurial and intraneural tumour invasion and one showed epidural venous invasion. CONCLUSION Although rare, WT-associated spinal disease may cause permanent neurological deficit, adding considerably to the burden of disease. In developing countries where patients present late, the prognosis is poor, however surgery may provide immediate relief of compression symptoms and biopsy material. The treatment of choice will depend on the facilities available and the clinical circumstances.
Collapse
|