Wilms’ Tumor: A 24-year Retrospective Study from a Single Center

Abstract

Medical records of 71 children with Wilms' tumor at Sisli Etfal Education and Research Hospital between 1990 and 2014 were reviewed. Mean age at diagnosis was 3.11 years (2 days-7 years). Male to female ratio was M/F = 6/10. The incidence of associated anomaly was 16.9%. Clinical manifestations included abdominal mass (89%), hematuria (30%), hypertansion (25%), abdominal pain (15%), fever (5%), restlessness (2%), weight loss (2%), varicocele (1%). Ultrasound (USG) was the most often initial study in a child presenting with abdominal mass. Doppler USG was also made to evaluate the inferior vena cava (IVC) for the presence of tumor extension in children with renal mass. The left kidney was affected in 33 patients (46.5%), the right was affected in 31 patients (43.7%). Two patients was extrarenal (2.8%). And 5 patients (7.04%) were bilateral on the presentation. Preoperative chemotheraphy was done in 14 cases. In 63 patients with unilateral Wilm tm, unilateral radical nefrectomy is performed. In one patient with solitary kidney, nephron sparing surgery (NSS) is performed. In 3 patients with bilateral tm NSS is performed and in 2 patients with bilateral Wilms' tm NSS is performed in one side and nefrectomy on the other side. Out of 71 Wilms tumor (WT) patients, 17 of them has been out of our follow. And 4 of them are died. Ten of them has metastases. Forty children are under follow with no metastases. Patients with WT needs a multimodal, multidisiplinary treatment with the cooperation of pediatric oncologist and pediatric surgeon and needs close follow-up.

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

“…They reported that the prevalence of varicoceles was < 1% in boys aged 2–10. In the child less than 9 years of age, where acute varicoceles are normally not seen, a renal or retroperitoneal tumour is a possibility and should be excluded [ 165 ].…”

Varicocele with an Abdominal Mass

“…Varicocele is an unusual presentation (~1%) of Wilms' tumor. 5 Angioinvasion of the tumor into renal vein and inferior vena cava results in venous engorgement of spermatic veins resulting in varicocele. Left spermatic vein, unlike right spermatic vein, drains perpendicularly into the renal vein and is more prone for compression because of any mass lesion arising from kidney explaining the common presentation on the left side.…”

Bilateral nephroblastoma in children. Description of the clinical case

“…Нефробластома (опухоль Вильмса) -одна из наиболее часто встречающихся злокачественных эмбриональных опухолей у детей. С точки зрения эмбриогенеза нефробластома представляет собой солидную злокачественную опухоль, состоящую из производных нефрогенной ткани на разной степени дифференцировки [1].…”

“…Обычно опухоль Вильмса возникает спорадически, в 2 % наблюдений она имеет семейный характер, в 10 % случаев она развивается у детей с пороками развития (чаще мочеполовой системы) или генетическими синдромами. Частота встречаемости заболевания среди девочек и мальчиков одинакова [1].…”