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

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)