Diagnosis Of Wilms Research Articles

Clinicopathologic Evaluation of Wilms’ Tumor in a Tertiary Care Children Hospital

Background and Objective: Wilms’ tumor has been recognized as the most common primary malignant tumor of kidney at childhood. It comprises 5-6% of tumors in the childhood period, and manifests with various clinical symptoms. Since there have been no sufficient studies in this field in Bangladesh, therefore, this study was conducted to investigate its histopathology and different clinical symptoms. Materials and Methods: This study was carried out on existing data from 70 children with a diagnosis of Wilms’ tumor at Bangladesh Shishu Hospital during the years 2015-2020. In this regard, personal and disease-related characteristics of patients including age, sex, tumor stage, histopathology, and involved kidney were evaluated and SPSS software and other statistical tests were used for data analysis. Results: The most common age of disease incidence was 2-4 years. In this regard, male and female ratio was 1.5. Meanwhile, the prevalence of an abdominal mass as the most common symptom was 85.0%. Left kidney was involved in 50% of cases and 58 (82.86%) of patients had a favorable histology. In addition, there was a significant correlation between site of kidney involvement and tumor histology (p<0.005). Conclusion: Considering the achieved advances in the diagnosis and treatment of Wilms’ tumor, early diagnosis with regard to clinical symptoms can have a valuable role in its effective management.

Role of Ultrasonography in the Diagnosis of Wilms' Tumour.

Background. Wilms’ tumour or nephroblastoma is the most common renal malignancy encountered in the paediatric population. Imaging findings are of great importance to the surgeon, the oncologist and the radiologist in the diagnosis and the staging and surveillance of this tumour. Material and Methods. This study was carried out as a 10-year retrospective study of patients who were diagnosed with Wilms’ tumour. Results. The study included 12 boys and 11 girls. Ultrasound and computed tomography were performed in all cases. Ultrasonography was found to be superior to the CT examination when approximating the antero-posterior and transverse diameters; the computer-tomographic examination is cited as superior for estimating the invasion of nephroblastomas. Conclusions: Ultrasound has been shown to be effective in detecting the rupture of the renal capsule, tumour calcifications and invasion of the renal vein, pelvis and ureter. However, ultrasound cannot replace CT in the detection of lymphadenopathy and the invasion of adjacent organs.

Re: Evidence for a Delay in Diagnosis of Wilms' Tumour in the UK Compared with Germany: Implications for Primary Care for Children.

No AccessJournal of UrologyUrological Survey1 Nov 2017Re: Evidence for a Delay in Diagnosis of Wilms’ Tumour in the UK Compared with Germany: Implications for Primary Care for Children Douglas A. CanningMD Douglas A. CanningDouglas A. Canning More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.08.043AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Re: Evidence for a Delay in Diagnosis of Wilms’ Tumour in the UK Compared with Germany: Implications for Primary Care for Children." The Journal of Urology, 198(5), pp. 968–969 © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 5November 2017Page: 968-969 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.MetricsAuthor Information Douglas A. Canning More articles by this author Expand All Advertisement PDF downloadLoading ...

Evidence for a delay in diagnosis of Wilms’ tumour in the UK compared with Germany: implications for primary care for children

The UK has a longstanding system of general practice which provides the vast majority of primary care, including that for children. It acts as a 'gatekeeper' to more specialist care....

Cytodiagnostic Utility of Wilms’ Tumor

Abdominal mass is a frequent presenting symptom in the pediatric surgery OPD and many of them are diagnosed as Wilms’ tumor. FNAC has been recognised as a useful tool for diagnosis of pediatric abdominal masses. But the role of FNAC in the diagnosis of Wilms’ tumor is still controversial. FNAC in operable tumors was performed sometimes only when the diagnosis was in doubt on radiological evalution. It is a safe technique that does not upstage the tumor and permits positive diagnosis of nephroblastoma in almost all aspirates. Here we report a case of a two and half year old girl child admitted to hospital with right subhepatic mass. Cytodiagnosis of Wilms’ tumor was given. In the present case, our aim is to stress the utility and preoperative diagnostic role of FNAC in pediatric tumor.

Immature teratoma of kidney in a 5-month-old child

We report a rare case of immature renal teratoma in a 5-month-old female infant. The patient presented with abdominal mass, which was found to arise from the left kidney. The preoperative diagnosis of Wilms’ tumor was based on clinical and imaging findings. The patient was managed with nephrectomy and had normal recovery. The histopathological examination of nephrectomy specimen revealed grade 2 immature teratoma. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 425-527 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7875

The Polysialyltransferases Interact with Sequences in Two Domains of the Neural Cell Adhesion Molecule to Allow Its Polysialylation

The neural cell adhesion molecule (NCAM) is the major substrate for the polysialyltransferases (polySTs), ST8SiaII/STX and ST8SiaIV/PST. The polysialylation of NCAM N-glycans decreases cell adhesion and alters signaling. Previous work demonstrated that the first fibronectin type III repeat (FN1) of NCAM is required for polyST recognition and the polysialylation of the N-glycans on the adjacent Ig5 domain. In this work, we highlight the importance of an FN1 acidic patch in polyST recognition and also reveal that the polySTs are required to interact with sequences in the Ig5 domain for polysialylation to occur. We find that features of the Ig5 domain of the olfactory cell adhesion molecule (OCAM) are responsible for its lack of polysialylation. Specifically, two basic OCAM Ig5 residues (Lys and Arg) found near asparagines equivalent to those carrying the polysialylated N-glycans in NCAM substantially decrease or eliminate polysialylation when used to replace the smaller and more neutral residues (Ser and Asn) in analogous positions in NCAM Ig5. This decrease in polysialylation does not reflect altered glycosylation but instead is correlated with a decrease in polyST-NCAM binding. In addition, inserting non-conserved OCAM sequences into NCAM Ig5, including an "extra" N-glycosylation site, decreases or completely blocks NCAM polysialylation. Taken together, these results indicate that the polySTs not only recognize an acidic patch in the FN1 domain of NCAM but also must contact sequences in the Ig5 domain for polysialylation of Ig5 N-glycans to occur.

Diagnosis of Wilms' tumor using near-infrared Raman spectroscopy

Diagnosis of Wilms' tumor using near-infrared Raman spectroscopy

Tumor de Wilms extra-renal: relato de caso

Um caso de tumor de Wilms extra-renal de localização retroperitoneal em uma paciente do sexo feminino de dois anos de idade é apresentado, associado a revisão de literatura. Foram realizados exames de radiografia simples do abdome, urografia excretora, ultra-sonografia e tomografia computadorizada sem e com contraste, que evidenciaram a presença de massa retroperitoneal adjacente ao rim direito. A paciente foi submetida a intervenção cirúrgica, com ressecção de toda a massa, sendo o diagnóstico de tumor de Wilms confirmado com exame anatomopatológico. O tumor de Wilms extra-renal é uma entidade extremamente rara e maligna, descrito na literatura principalmente sob a forma de relato de caso. Pode ocorrer no retroperitônio, útero e ovários, canal inguinal, testículos, pele, e até mesmo no tórax. O mecanismo exato que poderia explicar a ocorrência deste tumor em tecido extra-renal não foi bem estabelecido ainda. O diagnóstico é feito através do estudo anatomopatológico da lesão, geralmente após intervenção cirúrgica.

Diagnosis and Referral of Wilms?? Tumor

Wilms' Tumor, also know as nephroblastoma, is a childhood renal tumor. The assessment and diagnosis of a Wilms' tumor is one of the many challenges faced in the primary care setting. This article presents a brief review of Wilms' tumor in the pediatric population and its occurrence in a case presentation.

Logistic regression analysis of small round cell neoplasms: A cytologic study

The diagnosis of small round cell neoplasms (SRCN) in children is difficult by both histologic and cytologic methods. These neoplasms are unified morphologically by the scanty cytoplasm surrounding relatively round nuclei containing a primitive chromatin pattern. Further categorization is achieved histologically by the recognition of architectural differentiation and cytoplasmic features. Numerous series and case reports documenting the cytologic features of SRCN have been published in the English-language literature, but relatively few studies have statistically analyzed the diagnostic utility of these features. Our logistic regression analysis of 59 cases of SRCN indicates that the presence of an extremely scanty cytoplasm favors the diagnosis of Ewing's sarcoma (P = 0.004), as does the positive expression of cytoplasmic vacuoles (P = 0.02). Strap or tadpole cells closely correlate with the diagnosisof rhabdomyosarcoma (P < 0.001). The positive expression of rosettes strongly supports the presence of a neuroblastoma (P < 0.001). The diagnosis of Wilms' tumor is confirmed by the expression of tubules (P < 0.001). The presence of lymphoglandular bodies strongly favors the diagnosis of lymphoma (P < 0.001). While some cytologic features are highly correlated with specific SRCN, these features are not invariably present, and definitive diagnosis may require immunohistochemical or ultrastructural analysis performed on cell block material. Diagn. Cytopathol. 1999;20:271–277. © 1999 Wiley-Liss, Inc.

Logistic regression analysis of small round cell neoplasms: a cytologic study.

The diagnosis of small round cell neoplasms (SRCN) in children is difficult by both histologic and cytologic methods. These neoplasms are unified morphologically by the scanty cytoplasm surrounding relatively round nuclei containing a primitive chromatin pattern. Further categorization is achieved histologically by the recognition of architectural differentiation and cytoplasmic features. Numerous series and case reports documenting the cytologic features of SRCN have been published in the English-language literature, but relatively few studies have statistically analyzed the diagnostic utility of these features. Our logistic regression analysis of 59 cases of SRCN indicates that the presence of an extremely scanty cytoplasm favors the diagnosis of Ewing's sarcoma (P = 0.004), as does the positive expression of cytoplasmic vacuoles (P = 0.02). Strap or tadpole cells closely correlate with the diagnosis of rhabdomyosarcoma (P < 0.001). The positive expression of rosettes strongly supports the presence of a neuroblastoma (P < 0.001). The diagnosis of Wilms' tumor is confirmed by the expression of tubules (P < 0.001). The presence of lymphoglandular bodies strongly favors the diagnosis of lymphoma (P < 0.001). While some cytologic features are highly correlated with specific SRCN, these features are not invariably present, and definitive diagnosis may require immunohistochemical or ultrastructural analysis performed on cell block material.

MALIGNANT NEOPLASMS AFTER TREATMENT FOR METACHRONOUS BILATERAL WILMS' TUMOR: A Literature Review

Information regarding malignant neoplasms after treatment for metachronous bilateral Wilms' tumor is limited. A MEDLINE search was performed of all English-language articles from 1950 to 1997 pertaining to metachronous bilateral Wilms' tumor. A total of 108 different cases were identified and analyzed. Mean follow-up was 5.8 years after initial diagnosis of Wilms' tumor (range, 1 month to 25.6 years). Eleven of 63 evaluable children (17.5%) had a congenital anomaly. Four patients (3.7%) developed a malignant neoplasm after treatment of a metachronous bilateral Wilms' tumor. Three of 18 patients followed for at least 10 years developed a solid tumor, including two sarcomas in the irradiated areas. Two of the 4 children who developed a malignant neoplasm had a congenital anomaly. Malignant neoplasms after treatment for metachronous bilateral Wilms' tumor can occur. Health-care professionals caring for these patients should be aware of this late sequelae of treatment.

Metachronous Bilateral Wilms' Tumor. The Importance of Time Interval to the Development of a Second Tumor

BACKGROUND Information regarding survival and prognostic factors in children with metachronous bilateral Wilms' tumor is limited. METHODS A literature search of English language articles from 1950-1996 was performed. A total of 108 of 123 children with metachronous bilateral Wilms' tumor from 30 studies were evaluable for analysis. The children were classified according to the time interval to the development of a contralateral Wilms' tumor (< 18 months vs. ≥ 18 months). RESULTS Kaplan-Meier analysis rates of overall survival for metachronous bilateral Wilms' tumor were 49.1% and 47.2% at 5 and 10 years, respectively. The median time interval to the development of a second tumor was 23.1 months. Of 106 children, 102 (96.2%) had a metachronous presentation of Wilms' tumor by 5 years. In children ages < 2 years and children ages 2-5 years, 95.2% and 93.9%, respectively, of contralateral tumors appeared within 60 months. For children ages ≥ 5 years, all contralateral kidney tumors appeared by 54 months. Analysis of overall survival of patients with a time interval of < 18 months and ≥ 18 months showed a 10-year survival of 39.6% and 55.2%, respectively (P = 0.024, log rank test). CONCLUSIONS Children with a metachronous bilateral Wilms' tumor who developed a contralateral tumor ≥ 18 months from the initial diagnosis of Wilms' tumor had a better overall survival than children with a time interval of 5 years after initial diagnosis of Wilms' tumor may not be necessary because > 95% of children had a time interval to the development of a second tumor of ≤ 60 months. Cancer 1998;82:415-20. © 1998 American Cancer Society.

Staging problems in the pre‐operative chemotherapy of Wilms' tumour

To determine the effect of the International Society of Paediatric Oncology (SIOP) Wilms' tumour protocols (pre-operative chemotherapy based on clinical and radiological findings, with no prior tumour verification by open or needle biopsy) on subsequent intra-operative tumour diagnosis and staging. The diagnosis and staging of possible Wilms' tumour by clinical, ultrasonographic and radiological assessment were compared with the intra-operative findings in 14 consecutive children (1-12 years of age) treated between 1989 and 1994. A diagnosis of Wilms' tumour was histologically verified in 11 of 14 children. In two children, verification was not possible due to complete necrosis of the tumour following pre-operative chemotherapy. In a 12-year-old boy with an estimated stage IV disease due to a solitary lung metastasis, a renal cell carcinoma was revealed in the nephrectomy specimen while subsequent thoracotomy revealed dysmorphic but not malignant tissue. The estimated tumour stage was correct with regard to localized or metastatic disease in nine of 11 children with histologically confirmed Wilms' tumour, while in two children with an estimated stage II tumour, liver metastases were found intra-operatively and the tumour was upstaged to IV. Exact tumour diagnosis and staging was difficult in these patients. Although the accuracy of tumour staging depends on the sensitivity of radiological and ultrasonographic examinations, difficulties in tumour diagnosis may be overcome by biopsies of the primary tumour. The justification of upstaging a low-stage I/II tumour to stage III, provoking a more intense post-operative treatment, should be proven by prospective randomized studies. The decision to perform a primary tumour biopsy would be facilitated if possible subsequent deterioration of outcome could be excluded.

Prognostic implications of hepatic adhesion, invasion, and metastases at diagnosis of Wilms' tumor : P.R.M. Thomas, S.J. Shochat, P. Norkool, et al. Cancer 68:2486–2488, (December), 1991

Prognostic implications of hepatic adhesion, invasion, and metastases at diagnosis of Wilms' tumor : P.R.M. Thomas, S.J. Shochat, P. Norkool, et al. Cancer 68:2486–2488, (December), 1991

Prognostic implications of hepatic adhesion, invasion, and metastases at diagnosis of Wilms' tumor. The National Wilms' Tumor Study Group.

In the Third National Wilms' Tumor Study, (NWTS-3), 190 patients with Favorable Histology (FH) Wilms' tumor (WT) were identified as having tumor adherent to, directly invading, or metastatic to the liver at diagnosis. Analyses of the 3-year relapse-free survival and survival of these patients show that adhesion to the liver surface, direct invasion of the liver, and liver metastases have no additional detrimental effect on prognosis stage-for-stage. The authors conclude that hepatic involvement, when present at the time of diagnosis, should not be regarded as different from other patterns of the disease. Treatment policies should follow those appropriate for stage.

Hypertension in long-term survivors of childhood renal cancers.

The prevalence of hypertension was investigated in 119 adults who have survived for up to 53 years following the diagnosis of renal cancer in childhood (Wilms' tumor, 116 patients; renal carcinoma, three patients). Twenty-four (20%) have developed definite or borderline hypertension, as compared with 18.1 cases expected based on US population rates (relative risk [RR], 1.3; 95% confidence interval [CI], 0.9 to 2.0; P = .20). This nonsignificant excess is due to the heightened prevalence of definite hypertension among one subgroup of male patients. The findings are not explained by cigarette smoking, obesity, age, and stage at diagnosis of Wilms' tumor, or family history of hypertension. A case-comparison analysis within the cohort showed no consistent hypertensive effect associated with radiation therapy dose, radiotherapy concurrent with dactinomycin chemotherapy, or extent of renal surgery. Hypertension is not a common late complication of Wilms' tumor in our patients.

Bilateral multifocal Wilms' tumor

A three-year-old boy who presented with symptoms of peritonitis was found to have four Wilms' tumors affecting both kidneys. Individual enucleation of three tumors in the right kidney plus left lower nephrectomy were performed. Chemotherapy was administered for one year. The diagnosis of Wilms' tumor was confirmed on each specimen by the histologic studies. The child remains asymptomatic and developing normally six years after the initial surgical treatment. Bilateral partial nephrectomies is the most conservative of the surgical treatments available for bilateral Wilms' tumor.

Second Neoplasms After Wilms' Tumor in Childhood

The frequency of second neoplasms was examined among 487 Wilms' tumor patients treated at the Dana-Farber Cancer Institute and Children's Hospital of Boston, 1927-81. Thirty study patients (6%) developed second primary tumors: 11 cancers, 16 benign tumors, and 3 borderline neoplasms. Cumulative probability of a second cancer was 18% (standard error, 6%) in 34 years after diagnosis of Wilms' tumor. The subgroup of 412 patients who had received radiotherapy for Wilms' tumor developed all 11 second cancers, which included 1 skin carcinoma, 1 acute leukemia, and 9 solid internal cancers (expected, 0.7 cancers other than skin carcinoma; P less than .001). After exclusion of the secondary leukemia, all but 1 second cancer arose within the radiotherapy field. Concurrent therapy with dactinomycin did not reduce the risk of a radiation-associated cancer. Second cancer was the cause of death in 7 patients.