Abstract
Background: Wilms’ tumor is the commonest pediatric renal tumor and has a peak incidence between two and five years of age. Clinicopathological staging of Wilms’ tumor is the single most important prognostic determinant and therefore histopathological analysis is important.Methods: This is a retrospective study of diagnosed cases of Wilms’ tumor received as surgical and autopsy specimens in the department of pathology in a major teaching hospital over a period of ten years. Clinical, biochemical and radiological details were retrieved from medical records. Information regarding routine gross and microscopic examination findings (paraffin sections) was retrieved from departmental recordsResult: We received 24 nephrectomies, three post mortem specimens and eight biopsies. Maximum cases were found between two to five years of age with no gender predilection. Most patients presented with abdominal lump. Grossly, majority specimens had a variegated cut surface whereas two cases had a predominantly cystic appearance. Microscopically, 26 cases showed classic triphasic histology. Eight out of 27 cases (nephrectomies and post mortem cases) received preoperative chemotherapy. All cases showed extensive chemotherapeutic response and one case showed post – chemotherapy change mimicking a cystic partially differentiated nephroblastoma (CPDN). Of the remaining 19 cases which did not receive chemotherapy, only one case had an unfavorable histology. A rare case of CPDN was reported.Conclusion: Histopathologist plays an important role in the diagnosis of Wilms tumor. Clinical, radiological and pathological correlation is necessary in the final reporting of these cases.DOI:10.21276/APALM.1606
Highlights
Wilms’ tumor is the commonest pediatric renal tumor and comprises 85% of these tumors
The presence of anaplasia differentiates favourable from unfavourable histology
Wilms’ tumor accounts for 6% of pediatric malignancies and >95% of kidney tumors in children.[2]Most of the patients are found in the age group of 2 to 5 years like in our study. [3],[4] Wilms’ tumor has been reported rarely as a congenital neoplasm and in adults
Summary
Wilms’ tumor is the commonest pediatric renal tumor and comprises 85% of these tumors It has a peak incidence between two and five years of age and the patients usually present with an abdominal mass. Histopathology, percentage response to chemotherapy and clinicopathological staging of Wilms’ tumor are the most important prognostic determinants and play a decisive role in further management of the patient. This highlights the importance of a complete histopathology report in such cases. Wilms’ tumor is the commonest pediatric renal tumor and has a peak incidence between two and five years of age. Clinicopathological staging of Wilms’ tumor is the single most important prognostic determinant and histopathological analysis is important
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