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Neonatal Wilms tumor

M L Ritchey1, R G Azizkhan, J B Beckwith

  • 1Division of Pediatric Surgery, University of Texas-Houston, USA.

Journal of Pediatric Surgery
|June 1, 1995
PubMed
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This study analyzed 15 neonatal Wilms tumors, finding abdominal masses common. Infants without chemotherapy or with nephrogenic rests require closer monitoring for potential relapse.

Area of Science:

  • Pediatric Oncology
  • Neonatal Surgery
  • Nephrology

Background:

  • Neonatal renal tumors, particularly Wilms tumors, are exceptionally rare occurrences.
  • Early detection and management are crucial for improving outcomes in affected infants.

Purpose of the Study:

  • To review the clinical presentation, management, and outcomes of 15 infants diagnosed with Wilms tumors within the first month of life.
  • To identify prognostic factors and recommend optimal follow-up strategies for neonatal Wilms tumors.

Main Methods:

  • Retrospective review of 15 cases of neonatal Wilms tumors diagnosed within the first 30 days of life.
  • Analysis of presenting symptoms, diagnostic methods, surgical interventions, adjuvant therapies, and patient outcomes.

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Main Results:

  • The most frequent presentation was an abdominal mass detected during routine newborn examination; three cases were identified via antenatal ultrasound.
  • All infants underwent primary tumor excision. Five received no adjuvant chemotherapy; one relapsed and died. The remaining are alive with a median follow-up of 31 months.
  • Eight tumors showed evidence of nephrogenic rests, a potential indicator for relapse.

Conclusions:

  • Neonatal Wilms tumors necessitate prompt surgical management.
  • Children not receiving adjuvant chemotherapy or those with nephrogenic rests require intensified surveillance, including frequent physical and imaging examinations, to detect early signs of recurrence.