RESUMO
A case report is presented of a Wilms' tumour in a three-year-old child. Direct intravascular extension into the heart led to a fatal outcome. Though a rare complication, clinical suspicion, combined with appropriated investigation and management, should lead to salvage of such a patient (AU)
Assuntos
Humanos , Feminino , Pré-Escolar , Neoplasias Renais/diagnóstico , Neoplasias Renais/terapia , Neoplasias Cardíacas/secundário , Tumor de Wilms/diagnóstico , Tumor de Wilms/terapia , Ecocardiografia , Veia Cava Inferior/diagnóstico por imagem , Átrios do Coração/diagnóstico por imagemRESUMO
Of the twenty-nine children with solid tumours treated at the University Hospital of the West Indies (UHWI) between January, 1972 and December, 1991, there were twenty-eight cases of nephroblastoma and one of mesoblastic nephroma. Peak incidence was between the ages of two and four years. Twenty-five children had radical nephrectomy while one had bilateral partial nephrectomy. In thirteen cases, pre-operative chemotherapy and radiotherapy was used. Post-operative chemotherapy and radiotherapy were used in 24 and 13 cases, respectively. Stage of the tumour was the most decisive factor influencing the outcome. Whereas there was 100 percent cure rate in Stages I and II, Stage III had only a 55.5 percent survival rate and non of the Stage IV survived. Bilateral (Stage V) tumours are curable if individual tumours are localised, as in one of the two cases. The benign mesoblastic nephroma, in a one-month-old infant, was cured by nephrectomy alone. While the present therapy of radical nephrectomy along with combination chemotherapy is satisfactory for early stages, more aggressive adjuvant therapy is needed for improving the results in Stages III and IV (AU)
Assuntos
Lactente , Pré-Escolar , Criança , Humanos , Masculino , Feminino , Tumor de Wilms , Neoplasias Renais , Tumor de Wilms/diagnóstico , Tumor de Wilms/mortalidade , Tumor de Wilms/terapia , Nefropatias/diagnóstico , Nefropatias/mortalidade , Nefropatias/terapia , Resultado do Tratamento , Estudos Retrospectivos , Prognóstico , Estadiamento de Neoplasias , Nefroma MesoblásticoRESUMO
Between January 1972 and December 1991, twenty-nine children with solid renal tumours were treated at the UHWI. Twenty-eight of these were nephroblastomas and one was a mesoblastic nephroma. Peak incidence was between the ages of two and four years. Abdominal distension, mass and pain were the common presenting features. A palpable mass was present in all, which could be confirmed by intravenous urogram and/or ultrasound to be of renal origin. Chest X-ray revealed metastic lesions in six cases. Twenty-five children had radical nephrectomy while one had bilateral partial nephrectomy. In thirteen cases, pre-operative chemotherapy ñ radiotherapy was used. Post-operative chemotherapy and radiotherapy were used in twenty-four and thirteen cases, respectively. Stage of the tumour was the most decisive factor influencing the outcome. Whereas there was a 100 per cent cure rate in Stages I and II, Stage III had only 55.5 per cent survival rate and none of the Stage IV survived. The histology or size of the tumour were not critical factors. While the present therapy of radical nephrectomy along with the combination chemotherapy is unsatisfactory for early stages, more aggressive chemotherapy and improved radiotherapy are needed for improving the results in Stages III and IV. Bilateral (Stage V) tumours are curable if individual tumours are localised, as in one of two cases. The benign mesoblastic nephroma, in a one-month old infant, was cured by nephrectomy alone (AU)
Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Neoplasias Renais/terapia , Tumor de Wilms/cirurgia , Nefroma Mesoblástico/terapiaRESUMO
Wilms'tumor (nephroblastoma) is a common childhood tumour, with a reported annual incidence in the United States of 7.8 cases per million of population aged one to 14 years. Horseshoe-shaped kidney is a congenital malformation with a recognized risk of complications, yet an associated nephroblastic is exceeding rare. A case of this simultaneous but unsuspected occurrence of a Wilms' tumour co-existing within a horseshoe kidney, and diagnostic dilemma encountered is presented. (Au)
Assuntos
Humanos , Pré-Escolar , Feminino , Tumor de Wilms/diagnóstico , Rim/anormalidadesRESUMO
A case of nephroblastoma in a 6-day old infant, treated by nephrectomy only, is reported. This is probably the youngest successfully treated case. The importance of thorough routine physical examination of infants is stressed. Intrasagittal injection for pyelography is mentioned as an alternative to intraveneous, subcutaneous and intramuscular injection. Local anesthesia is recommended for nephrectomy in infants with small tumors. The literature on the clinical aspect of the disease is reviewed (Summary)