Extrarenal Wilms' Tumor : A Report of Two Pediatric Cases

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  • 腎外性ウイルムス腫瘍の2例

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Abstract

Extrarenal Wilms' tumor is rare neoplasm. We report two cases of this tumor occurring in children. Case 1 : A 5-years and 10-months old boy was admitted to our hospital because of abdominal pain. A smooth and hard mass was palpable around his navel. On CT scan, a well-defined, solid mass was found in the abdominal cavity. At surgery, it was found that an encapsulated tumor attached to abdominal aorta. Pathological findings was compatible with nephroblastic type nephroblastoma. Actinomycin D and vincristine were administered and the patient has been well with no evidence of recurrence nor metastasis 2 years and 11 months after operation. Case 2 : A 2-years and 4-months old boy was admitted with abdominal hard mass. CT examination showed a well-defined solid mass in abdominal cavity. Paraaortic lymphnode swelling and the right hydronephrosis were also detected. More over, chest X-rays showed multiple lung metastasis. Ten days after admission, patient underwent open biopsy and a right nephrostomy. In operation, tumor was found located at the retroperitoneum and detached from bilateral kidney. The biopsy showed epithelial type of nephroblatoma. With these clinical and pathological findings, the legion was diagnosed as the extrarenal Wilms' tumor with lung metastasis. Actinomycin D, vincristine, adriamycin and cyclophosphamide were preceeded to the radical operation. Twelve weeks after the initiation of chemotherapy, the tumor was removed completely. Adjuvant radiotherapy to abdomen and lung, and chemotherapy were carried out for one year. Patient has been well with no evidence of recurrence nor metastasis for 2 years and 3 months after initial operation.

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