Intracardiac extension of a Wilms' tumour

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)

Outcome of solid renal tumours in children at the University Hospital of the West Indies

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)

Solid renal tumours in children at the University Hospital of the West Indies - abstract

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)

Morphology of the lymph nodes draining renal adenocarcinoma in relation to immunological functions

One hundred and thirty-four lymph nodes from forty-seven patients with renal adenocarcinoma and the same number of regional nodes from sixty-one patients with gastric ulcer were evaluated histologically by using the standardized reporting system introduced by Cottier, Turk & Sobin (1973). Special attention was focused on the morphologic features which correlate with the immunological responses of the antibody response were found to be active more often in the ulcer series than in the cancer series. On the other hand, the constituents of the cell-mediated immune system were depressed more often in the nodes draining renal carcinomas. The significance of the different immune responses evoked by these two diseases is discussed and the conclusion is drawn that there is some degree of derangement of both humorlal and cell-mediated immune systems in the regional lymph nodes of renal adenocarcinoma. The applicability of the reporting system used in assessing the morphology of human lymph nodes is to be emphasized.(AU)

Renal carcinoma in pregnancy

Three cases of renal adeno-carcinoma in pregnant women are reported. Two have survived 5 years and the third, 4 years. These survival times are longer than those of adeno-carcinomas in non-pregnant women and in males at this hospital (Summary)