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Intraspinal Wilms' tumor metastases

S L Cohn1, M Hamre, M Kletzel

  • 1Department of Pediatrics, Northwestern University Medical Center, Chicago, Illinois.

Cancer
|May 1, 1994
PubMed
Summary

Intraspinal metastasis of Wilms' tumor is rare but serious. Early recognition and intensive multimodal therapy offer the best chance for long-term remission in patients with this challenging complication.

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Area of Science:

  • Pediatric Oncology
  • Nephrology
  • Neurology

Background:

  • Intraspinal metastasis from Wilms' tumor is an uncommon but severe complication.
  • This metastatic pattern is associated with a high mortality rate in affected children.

Observation:

  • Two patients with Wilms' tumor developed extradural metastasis, initially presenting with abdominal pain and no neurological deficits.
  • One patient experienced paraplegia due to cord compression from recurrent epidural metastases, while the second achieved disease-free remission after extensive treatment.

Findings:

  • A review of literature and National Wilms' Tumor Studies identified 27 additional cases of intraspinal metastasis.
  • Only four of these patients remained disease-free at the time of reporting, highlighting the aggressive nature of this condition.

Implications:

  • Early diagnosis and prompt intervention are crucial for managing intraspinal Wilms' tumor metastasis.
  • Intensive, multimodal treatment strategies, including chemotherapy, surgery, radiation, and bone marrow transplantation, can lead to long-term remission.

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