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Renal cell carcinoma in children: experience at a single institution in Japan
1Department of Urology, Tokyo Metropolitan Kiyose Children's Hospital, Japan.
Insights
Calcification on CT scans is a key indicator for pediatric renal cell carcinoma in children. Adjuvant interferon therapy shows promise for improving outcomes in select cases.
Area of Science:
- Pediatric Oncology
- Nephrology
- Radiology
Background:
- Renal cell carcinoma (RCC) is rare in children.
- Understanding its presentation and treatment is crucial for improving survival rates.
Purpose of the Study:
- To analyze the clinical presentation, treatment strategies, and survival outcomes of pediatric patients diagnosed with renal cell carcinoma.
- To identify characteristic imaging findings suggestive of pediatric RCC.
Main Methods:
- Retrospective review of pathological and hospital records of 4 Japanese children diagnosed with RCC between 1970 and 1998.
- Analysis of clinical presentation, imaging (CT scans), surgical procedures, and adjuvant therapies.
Main Results:
- The most common symptoms were gross hematuria (75%) and abdominal mass (50%).
- Characteristic calcification within the tumor or metastatic lesions was observed in 75% of patients on CT scans.
- All patients underwent nephrectomy with lymphadenectomy; 3 received adjuvant interferon therapy and remain recurrence-free.
Conclusions:
- Tumor calcification or high-density areas on CT scans are suggestive of pediatric renal cell carcinoma.
- Adjuvant interferon therapy may benefit select pediatric RCC patients.
- Further research with larger cohorts is needed to optimize diagnosis and treatment regimens.
Purpose:
We analyzed the presentation, treatment and survival of 4 children with renal cell carcinoma.
Materials And Methods:
We retrospectively reviewed the pathological and hospital records of 4 Japanese children diagnosed with renal cell carcinoma at our hospital from 1970 to 1998.
Results:
In the 1 boy and 3 girls with an average age of 8 years 7 months at diagnosis the most common presenting complaints were gross hematuria in 75% and a palpable abdominal mass in 50%. Computerized tomography revealed characteristic calcification within the tumor in 3 of the 4 patients (75%). In the remaining case the lesion had high density areas with microcalcification, as confirmed by histopathological study. In 2 patients with regional lymph node metastasis calcification was also observed in the metastatic lesions. Disease was stages I to III in 1, 1 and 2 patients, respectively. All patients underwent transabdominal nephrectomy with regional lymphadenectomy. One patient with stage I disease had multiple metastases 15 months later and died of disease 55 months postoperatively. However, the remaining 3 patients received adjuvant interferon therapy and they are without evidence of recurrence a mean of 51.3 months postoperatively.
Conclusions:
Calcification within the tumor and/or metastatic lesions or high density areas in the tumor on screening computerized tomography are characteristic findings suggestive of pediatric renal cell carcinoma. Adjuvant therapy with interferon may provide some benefit in select pediatric patients. Further studies of a larger number of pediatric renal cell carcinoma cases may be necessary to establish the optimal diagnostic and therapeutic regimen.