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Alijani B, Abbaspour E, Karimzadhagh S, Reihanian Z, Haghani Dogahe M, Jafari M, Jafari S, Zaresharifi N. First incidence of extrarenal wilms tumor within the spinal canal in the adult population: a novel case report and literature review. BMC Urol 2024; 24:119. [PMID: 38858693 PMCID: PMC11163749 DOI: 10.1186/s12894-024-01508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Wilms tumor (WT), also known as nephroblastoma, is rare in adults, accounting for merely 3% of all nephroblastomas or 0.2 cases per million individuals. Extrarenal Wilms tumor (ERWT) emerges outside the renal boundaries and comprises 0.5 to 1% of all WT cases, with even rarer incidences in adults. Oncogenic mutations associated with ectopic nephrogenic rests (NR) may contribute to ERWT development. Diagnosis involves surgical resection and pathology examination. Due to scarce cases, adults often rely on pediatric guidelines. We thoroughly searched PubMed, Scopus, and Web of Science databases to establish our case's uniqueness. To the best of our knowledge, this is the first documented incidence of extrarenal Wilms tumor within the spinal canal in the adult population. CASE PRESENTATION A 22-year-old woman with a history of congenital lipo-myelomeningocele surgery as an infant presented with a 6-month history of back pain. This pain gradually resulted in limb weakness, paraparesis, and loss of bladder and bowel control. An MRI showed a 6 × 5 × 3 cm spinal canal mass at the L4-S1 level. Consequently, a laminectomy was performed at the L4-L5 level to remove the intramedullary tumor. Post-surgery histopathology and immunohistochemistry confirmed the tumor as ERWT with favorable histology without any teratomatous component. CONCLUSION This report underscores the rarity of extrarenal Wilms tumor (ERWT) in adults, challenging conventional assumptions about its typical age of occurrence. It emphasizes the importance of clinical awareness regarding such uncommon cases. Moreover, the co-occurrence of spinal ERWTs and a history of spinal anomalies warrants further investigation.
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Affiliation(s)
- Babak Alijani
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abbaspour
- Department of Radiology, Poursina Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Sahand Karimzadhagh
- Clinical Research Development Unit of Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Zoheir Reihanian
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Maryam Jafari
- Student Research Committee, School of Medicine, Anzali International Campus, Guilan University of Medical Sciences, Rasht, Iran
| | - Seifollah Jafari
- Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nooshin Zaresharifi
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, 41937-13194, Iran.
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Hu LL, Guo ZQ, Dai P, Chen G, Tian T. Case report: Partial cystectomy for pheochromocytoma of the urinary bladder: A case report and review of literature. Front Cardiovasc Med 2022; 9:1092260. [PMID: 36601067 PMCID: PMC9806206 DOI: 10.3389/fcvm.2022.1092260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Pheochromocytomas are neuroendocrine tumors that produce catecholamines and can be difficult to diagnose. Bladder involvement is uncommon with pheochromocytoma. Hypertension (sometimes with hypertensive crisis coinciding with micturition), headache, hematuria and syncope, which are commonly associated with voiding, are the most prevalent symptoms. While transurethral resection may be performed in roughly 20% of patients, 70% require partial cystectomy and 10% require radical cystectomy. We present a case of pheochromocytoma with hypertension and syncope that was often associated with voiding, satisfactorily treated by partial cystectomy.
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Affiliation(s)
- Liang-Liang Hu
- Department of Urology, Shandong Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Zhong-Qiang Guo
- Department of Urology, Shandong Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Peng Dai
- Department of Urology, People's Hospital of Yicheng District, Zaozhuang, Shandong, China
| | - Gang Chen
- Department of Urology, Jinan Seventh People's Hospital, Jinan, Shandong, China
| | - Tao Tian
- Department of Urology, Shandong Zaozhuang Municipal Hospital, Zaozhuang, China,*Correspondence: Tao Tian ✉
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Willis KR, Sathe AA, Xing C, Koduru P, Artunduaga M, Butler EB, Park JY, Kurmasheva RT, Houghton PJ, Chen KS, Rakheja D. Extrarenal Anaplastic Wilms Tumor: A Case Report With Genomic Analysis and Tumor Models. J Pediatr Hematol Oncol 2022; 44:147-154. [PMID: 35129140 PMCID: PMC9035038 DOI: 10.1097/mph.0000000000002413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022]
Abstract
Primary extrarenal Wilms tumors are rare neoplasms that are presumed to arise from metanephric or mesonephric remnants outside of the kidney. Their pathogenesis is debated but has not been studied, and there are no reports of genomic descriptions of extrarenal Wilms tumors. We describe a diffusely anaplastic extrarenal Wilms tumor that occurred in the lower abdomen and upper pelvis of a 10-year-old boy. In addition to the clinical, histopathologic, and radiologic features, we describe the cytogenetic changes and exomic profile of the tumor. The tumor showed loss of the tumor suppressor AMER1, loss of chromosome regions 1p, 16q, and 22q, gain of chromosome 8, and loss of function TP53 mutation-findings known to occur in renal Wilms tumors. This is the first description of the exomic profile of a primary extrarenal Wilms tumor. Our data indicate that primary extrarenal Wilms tumors may follow the same pathogenetic pathways that are seen in renal Wilms tumors. Finally, we describe the establishment of first ever tumor models (primary cell line and patient-derived xenograft) from an extrarenal Wilms tumor.
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Affiliation(s)
| | - Adwait A Sathe
- Eugene McDermott Center for Human Growth and Development
| | - Chao Xing
- Eugene McDermott Center for Human Growth and Development
- Division of Pediatric Radiology, Department of Radiology
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
| | | | - Maddy Artunduaga
- Division of Pediatric Radiology, Department of Radiology
- Children's Health System of Texas, Dallas
| | - Erin B Butler
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
| | - Jason Y Park
- Departments of Pathology
- Children's Health System of Texas, Dallas
| | - Raushan T Kurmasheva
- Greehey Children's Cancer Research Institute
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX
| | - Peter J Houghton
- Greehey Children's Cancer Research Institute
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX
| | - Kenneth S Chen
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center
- Children's Health System of Texas, Dallas
| | - Dinesh Rakheja
- Departments of Pathology
- Children's Health System of Texas, Dallas
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Tang H, Lu M, Jiang S, Ren Y. Two rare cases of abdominal tumor in children: Answers. Pediatr Nephrol 2018; 33:1343-1345. [PMID: 29159474 DOI: 10.1007/s00467-017-3834-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Haojie Tang
- Radiology Department, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Mengtian Lu
- Radiology Department, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shan Jiang
- Radiology Department, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying Ren
- Radiology Department, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
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Ma Y, Zheng J, Feng J, Zhu H, Xiao X, Chen L. Ectopic nephrogenic rests in children: A series of 13 cases in a single institution. Pediatr Blood Cancer 2018; 65:e26985. [PMID: 29418060 DOI: 10.1002/pbc.26985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/22/2017] [Indexed: 11/11/2022]
Abstract
PURPOSE Ectopic nephrogenic rests (ENR) are extremely rare, and their diagnosis and treatment have not yet been standardized. Our study aimed to analyze the clinical and pathological features of ENR in children and explore the optimal methods for diagnosis and treatment. METHODS A retrospective, single-center, case series study of 13 children with ENR was performed. Clinical manifestations, work-up, pathological features, and treatment methods were analyzed, and the postoperative status was evaluated at follow-up. RESULTS The study cohort included seven males and six females aged 1/4-19 months, who were divided into two subgroups: group 1 (pure ENR, cases 1-3) and group 2 (ENR associated with teratoma, cases 4-13). The patients commonly presented with a painless mass or an incidental finding in surgery. The ENR were detected in the lumbosacral and sacrococcygeal region (five cases), retroperitoneal area (five cases), testis (one case), gubernaculum testis (one case), and stomach (one case). Radiological findings showed a mixed-density mass or a mixed-signal-intensity lesion in group 2. All the patients underwent surgical resection, and all except two were event-free in a follow-up period of 2-154 months. Case 8 showed recurrence, and extended surgery was performed. Case 7 developed metastases and received chemotherapy. CONCLUSIONS ENR are rare among children and have no specific clinical manifestations, lab tests, and radiological features. Different treatment strategies may be adopted based on the diagnosis. Complete resection can generally be achieved, and the prognosis is excellent in most cases. However, relapse or metastasis may occur in a small subset of patients. Close follow-up is mandatory to detect recurrence and metastasis early.
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Affiliation(s)
- Yangyang Ma
- Department of Pathology, Children's Hospital of Fudan University, Shanghai, China
| | - Jicui Zheng
- Department of Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Jiayan Feng
- Department of Pathology, Children's Hospital of Fudan University, Shanghai, China
| | - Haitao Zhu
- Department of Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Xianmin Xiao
- Department of Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Lian Chen
- Department of Pathology, Children's Hospital of Fudan University, Shanghai, China
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Bian T, Zhang J, Ge W, Feng J, Liu Y. Ectopic immature renal tissue in gubernaculum associated with undescended testis of a 1-year-old child: A case report. Medicine (Baltimore) 2017; 96:e9174. [PMID: 29384904 PMCID: PMC6393084 DOI: 10.1097/md.0000000000009174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Ectopic immature renal tissue (EIRT) is extremely rare in congenital malformations. Moreover, the fundamental pathogenesis of EIRT is still unclear and controversial. PATIENT CONCERNS The right scrotum of a 1-year-old man was found empty for a period of 1 month. B-ultrasonography revealed normal bilateral kidneys and a hypoechoic nodule in the right groin. DIAGNOSES Based on B-ultrasonography, surgery and pathological examination, we concluded a case of abnormally located and EIRT in the inguinal canal. INTERVENTIONS After pathological diagnosis, the patient was not treated with drugs. OUTCOMES One year after the operation, the patient recovered. LESSONS EIRT in gubernaculum is extremely rare. Because of the potential risk of malignant transformation, it is necessary to diagnose and treat it early.
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Affiliation(s)
| | | | - Wenliang Ge
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Mitra S, Singla N, Singh Sandhu G, Bal A. Ectopic Immature Renal Tissue Associated with Lipomeningomyelocele and Enteric Duplication Cyst: A Report of Two Cases. Fetal Pediatr Pathol 2016; 35:98-103. [PMID: 26882480 DOI: 10.3109/15513815.2015.1135495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ectopic immature renal tissue (EIRT) is a lesion rarely described in the literature. It shows the components of a nephrogenic rest including the blastema, epithelia, and stroma. We report two cases of EIRT in a 3-year-old female and an 8 months male child, associated with lipomeningomyelocele and an enteric duplication cyst, respectively, along with detailed immunohistochemical profile. Though there are a few cases of EIRT associated with teratoma, only two cases of EIRT associated with lipomeningomyelocele have been described in the English literature. Moreover, extensive literature search did not reveal any previous case report where EIRT had been documented in an enteric duplication cyst.
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Affiliation(s)
- Suvradeep Mitra
- a Department of Histopathology , PGIMER , Chandigarh , India
| | - Navneet Singla
- a Department of Histopathology , PGIMER , Chandigarh , India
| | | | - Amanjit Bal
- a Department of Histopathology , PGIMER , Chandigarh , India
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