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Wilms' tumour in infancy
1Department of Paediatric Surgery, University Hospital, Lund, Sweden.
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Wilms
Area of Science:
- Pediatric Oncology
- Nephrology
Background:
- Wilms' tumour (WT) is a rare kidney cancer affecting children.
- Infants under one year old present unique diagnostic and management challenges.
Purpose of the Study:
- To analyze the clinical behavior and management of Wilms' tumour in infants.
- To highlight the diagnostic difficulties and emphasize early recognition in this age group.
Main Methods:
- Retrospective review of 48 pediatric Wilms' tumour cases over 15 years.
- Analysis of treatment strategies (surgery vs. preoperative chemotherapy) based on age at diagnosis.
Main Results:
- Seven patients were diagnosed under one year of age.
- Infants under six months underwent primary surgery, while older infants received preoperative chemotherapy.
- Successful treatment outcomes were observed, including management of a contralateral relapse.
Conclusions:
- Wilms' tumour management in infants requires tailored approaches due to diagnostic uncertainties.
- Early consideration of Wilms' tumour is crucial for timely diagnosis and treatment in infants.
Abstract:
During a 15-y period, 48 children were treated for Wilms' tumour (WT). Seven of them were < 1 y of age at diagnosis. One child presented with non-traumatic haematuria, but in all the other children WT was revealed as a palpable abdominal mass at routine examination or investigation due to another disease. The four children under 6 months of age at diagnosis were primarily operated upon; the others received preoperative chemotherapy. Two children had chromosomal aberrations in the WT tumour specimen. The follow-up revealed that postoperatively six children are healthy with no evidence of relapse from WT, but one child had a contralateral relapse successfully enucleated. The clinical behaviour and management of WT in infants differ compared with that in older children. The diagnosis may be uncertain and it can be difficult to distinguish between malignant and non-malignant lesions. It is essential to realize the possibility of WT, even in children < 1 y of age.