Combiantion of Wilsm Tumor and Brain Tumor : A Case Report With Review of Literatures

DOI
  • Tamura Motoshi
    First Department of surgery, Hokkaido University school of medicine
  • Abe Tuyoshi
    First Department of surgery, Hokkaido University school of medicine
  • Hamada Hiromi
    First Department of surgery, Hokkaido University school of medicine
  • Sasaki Fumiaki
    First Department of surgery, Hokkaido University school of medicine
  • Hata Yoshinobu
    First Department of surgery, Hokkaido University school of medicine
  • Uchino Junichi
    First Department of surgery, Hokkaido University school of medicine
  • Takahashi Akihiro
    Department of Neurosurgery, Hokkaido University school of medicine
  • Aida Toshimitsu
    Department of Neurosurgery, Hokkaido University school of medicine
  • Abe Hiroshi
    Department of Neurosurgery, Hokkaido University school of medicine
  • Nojima Takayuki
    Department of Pathology, Hokkaido University Hospital

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Other Title
  • ウイルムス腫瘍と脳腫瘍の合併例 : 自験例ならびに集計例の検討

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Abstract

A 5 month old male baby was admitted with an abdominal mass. The patient had left facial nerve palsy since birth. At the age of 4 months, he was diagnosed as having right lateral ventricular tumor and cerebellar vermis tumor. The child underwent separate operations for the resections of both of the tumors. Irradiation and chemotherapy were not done before operation. On the basis of laboratoy investigation, IP, CT and US findings, he was diagnosed to have bilateral wilms tumors. After administraation of AM-D 10 μg/kg × 5, VCR 1.5mg/m^2 × 5, bilateral wilms tumors were resected. Both the tumors were well capsulated and were resected along with the capsule. The left and right tumors were 8.5 × 6.0cm 110g, 4.5×4.Ocm 40g respectively. Lymphonode metastasis were not detected. Right lateral ventricular tumor and cerebellar vermis tumor were diagnosed as PNET and medulloblastoma respectively. Bilateral renal tumors were diagnosed as wilms tumor, nephroblastic type, aboritve subtype. But it was not clear whether the tumors were rhabdoid tumor or clear cell sarcoma. After operation 1 cycle of AM-D, VCR were administrated and 30Gy of whole brain irradiation was done. Four months after the 1st operation, the patient died of reccurence of Wilms tumor. On autopsy multiple lung metastase, local recurrence, disseminated abdominal cavity metastasis of wilms tumor and disseminated intramedullary metastasis of brain tumor were detected. Fifteen combination cases of wilms tumor and brain tumor were collected from Japanese and English literatures. Many cases were combinations of rhabdoid type wilms tumor and PNET by Roke. Outcomes of 15 cases were very poor. It is necessary to improve the therapy of rhabdoid type wilms tumor.

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