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Wilms tumor: an update.

Turki Al-Hussain1, Afshan Ali, Mohammed Akhtar

  • 1Departments of *Pathology and Laboratory Medicine †Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.

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|April 10, 2014
PubMed
Summary
This summary is machine-generated.

Wilms tumor (WT) is a common childhood kidney cancer arising from embryonic tissue. Genetic abnormalities in WT1 and WT2 genes, along with other gene mutations, influence tumor type and prognosis, but effective treatments yield high cure rates.

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Area of Science:

  • Pediatric Oncology
  • Cancer Genetics
  • Developmental Biology

Background:

  • Wilms tumor (WT) is the most frequent pediatric kidney neoplasm.
  • WT originates from embryonic metanephric tissue, mimicking renal development.
  • Nephrogenic rests are considered precursor lesions for WT.

Purpose of the Study:

  • To describe the histological and genetic characteristics of Wilms tumors.
  • To correlate precursor lesions (nephrogenic rests) with specific genetic abnormalities and tumor subtypes.
  • To review the evolution of treatment strategies and outcomes for Wilms tumor.

Main Methods:

  • Histological classification of Wilms tumor components (stromal, blastemal, epithelial).
  • Genetic analysis of chromosomal abnormalities, including WT1, WT2, WTX, CTNNB1, and TP53.
  • Review of clinical data and treatment outcomes from major study groups (COG, SIOP).

Main Results:

  • WTs arise from intralobar or perilobar nephrogenic rests, each with distinct genetic profiles (WT1 vs. WT2 loci).
  • Intralobar WT often shows WT1 mutations and stromal predominance; perilobar WT is associated with WT2 imprinting abnormalities.
  • Genetic alterations in WTX, CTNNB1, TP53, and chromosomal regions 1p/16q impact prognosis.
  • Syndromic associations include WAGR, Denys-Drash, and Beckwith-Wiedemann syndromes.

Conclusions:

  • Wilms tumor pathogenesis involves specific genetic alterations linked to precursor lesions.
  • Understanding these genetic differences aids in predicting prognosis and guiding therapy.
  • Multicenter collaborative efforts have led to highly effective treatment protocols with excellent cure rates for pediatric Wilms tumor.