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The nonopacified kidney with Wilms' tumor
D K Nakayama1, W Ortega, G J D'Angio
1Department of Surgery, Children's Hospital of Philadelphia, PA 19104.
Journal of Pediatric Surgery
|February 1, 1988
Summary
Nonopacification of the kidney on intravenous pyelography (IVP) can indicate Wilms tumor, especially when tumor obstructs the collecting system. Further diagnostic studies are crucial for accurate diagnosis and treatment planning in pediatric kidney masses.
Area of Science:
- Pediatric Nephrology
- Urologic Oncology
- Diagnostic Imaging
Background:
- Wilms tumor is a common pediatric kidney cancer.
- Accurate preoperative diagnosis is essential for effective treatment.
- Intravenous pyelography (IVP) is a key diagnostic tool.
Purpose of the Study:
- To evaluate the significance of kidney nonopacification on IVP in suspected Wilms tumor cases.
- To determine the need for additional diagnostic studies in such scenarios.
Main Methods:
- Retrospective review of 56 cases with a preoperative diagnosis of Wilms tumor.
- Analysis of urographic findings, specifically nonopacification on IVP.
- Correlation of imaging findings with histopathological diagnoses and tumor characteristics.
Main Results:
- Ten percent of Wilms tumor patients and one renal cell carcinoma (RCC) patient showed kidney nonopacification on IVP.
- Collecting system blockage by tumor was the most common cause of nonopacification in Wilms tumor.
- Tumor extension into the renal pelvis occurred in 10% of Wilms tumor cases, frequently resulting in nonopacification (80%).
Conclusions:
- Kidney nonopacification on IVP in pediatric patients warrants further investigation for Wilms tumor.
- Collecting system involvement is a significant factor contributing to nonopacification.
- Diagnostic imaging protocols should be tailored to identify potential tumor extension and guide further studies.