Spinal cord compression in children with Wilms' tumour

Area of Science:

• Pediatric Oncology
• Nephrology
• Neurology

Background:

• Wilms' tumour (WT) is a rare pediatric kidney cancer.
• Spinal involvement with WT can lead to significant neurological deficits, including paraplegia.
• Outcomes for WT with spinal disease are often poor, especially in resource-limited settings.

Purpose of the Study:

• To describe the clinical, imaging, and histopathological characteristics of children with paraplegia secondary to Wilms' tumour.
• To evaluate therapeutic interventions and patient outcomes in a developing country context.
• To highlight the challenges and possibilities in managing this rare complication.

Main Methods:

• Retrospective review of patients with WT and paraplegia from 1984 onwards.
• Analysis of patient demographics, symptom duration, tumor stage, and treatment details.
• Review of histopathology from primary tumors and spinal biopsies.

Main Results:

• Five cases of WT-associated paraplegia were identified.
• Imaging revealed epidural masses causing spinal cord compression.
• Four patients died; neurological recovery was limited and often temporary, with poor prognostic indicators including tumor anaplasia and invasion.

Conclusions:

• WT-associated spinal disease, though rare, can result in permanent neurological deficits.
• Late presentation in developing countries significantly worsens the prognosis.
• Surgical decompression may offer symptomatic relief and diagnostic material, with treatment tailored to available resources.