CASE REPORT
Therapeutic management in a child with Wilms tumour and radiological features suggesting rupture at the time of diagnosis
1
Department of Paediatric Surgery, Traumatology and Urology, Poznan University of Medical Sciences, Poznan, Poland
2
Department of Paediatric Oncology, Haematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
3
Department of Paediatric Radiology, Poznan University of Medical Sciences, Poznan, Poland
4
Department of Health Promotion, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2021-07-12
Final revision date: 2021-08-29
Acceptance date: 2021-08-30
Publication date: 2022-01-11
Pediatr Pol 2021;96(4):288-291
KEYWORDS
TOPICS
ABSTRACT
Preoperative Wilms tumour rupture has been reported sporadically. But when identified, SIOP (Societe Internationale d’Oncologie Pediatrique) recommends that these patients should be upstaged to the 3rd stage.
The purpose of this publication was to present the clinical and radiological features of preoperative tumour rupture in our patient.
A 4-year-old girl was treated in the oncology department for a large Wilms tumour. The child presented inconclusive clinical and radiographical features of preoperative tumour rupture. Therefore, standard 4-week preoperative chemotherapy was used. Unfortunately, a tight connection between the cystic part of the tumour and the peritoneum became the cause of tumour rupture during surgery.
Not every child who meets the radiological criteria for preoperative tumour rupture should be upgraded. The radiological features of preoperative tumour rupture shouldvery much increase the caution of the surgeon.
The purpose of this publication was to present the clinical and radiological features of preoperative tumour rupture in our patient.
A 4-year-old girl was treated in the oncology department for a large Wilms tumour. The child presented inconclusive clinical and radiographical features of preoperative tumour rupture. Therefore, standard 4-week preoperative chemotherapy was used. Unfortunately, a tight connection between the cystic part of the tumour and the peritoneum became the cause of tumour rupture during surgery.
Not every child who meets the radiological criteria for preoperative tumour rupture should be upgraded. The radiological features of preoperative tumour rupture shouldvery much increase the caution of the surgeon.
REFERENCES (13)
1.
Brok J, Treger TD, Gooskens SL, et al. Biology and treatment of renal tumours in childhood. Eur J Cancer 2016; 68: 179-195.
2.
Le Rouzic MA, Mansuy L, Galloy MA, et al. Agreement between clinicoradiological signs at diagnosis and radiohistological analysis after neoadjuvant chemotherapy of suspected Wilms tumor rupture: Consequences on therapeutic choices. Pediatr Blood Cancer 2019; e27674.
3.
Graf N, Tournade MF, de Kraker J. The role of preoperative chemotherapy in the management of Wilms’ tumor. The SIOP studies. International Society of Pediatric Oncology. Urol Clin North Am 2000; 27: 443-454.
4.
Apoznański W, Patkowski D, Polok M, et al. Preoperative Wilms tumor rupture: Controversial diagnosis. Case report. Pediatr Pol 2017; 92: 786-788.
5.
Shamberger RC, Guthrie KA, Ritchey ML, et al. Surgery-related factors and local recurrence of Wilms tumor in National Wilms Tumor Study 4. Ann Surg 1999; 229: 292– 297.
6.
Burgers JM, Tournade MF, Bey P, et al. Abdominal recurrences in Wilms’ tumours: a report from the SIOP Wilms’ tumour trials and studies. Radiother Oncol 1986; 5: 175–182.
7.
Vujanić GM, Sandstedt B, Harms D, et al. Revised International Society of Paediatric Oncology (SIOP) working classification of renal tumors of childhood. Med Pediatr Oncol 2002; 38: 79–82.
8.
Ehrlich PF, Ritchey ML, Hamilton TE, et al. Quality assessment for Wilms’ tumor: a report from the National Wilms’ Tumor Study-5. J Pediatr Surg 2005; 40: 208– 213.
9.
Brisse HJ, Schleiermacher G, Sarnacki S, et al. Preoperative Wilms tumor rupture: a retrospective study of 57 patients. Cancer 2008; 113: 202–213.
10.
Khanna G, Naranjo A, Hoffer F, et al. Detection of Preoperative Wilms Tumor Rupture With CT: A Report From the Children’s Oncology Group. Radiology 2013; 266: 610-617.
11.
Fukuzawa H, Shiima Y, Mishima Y, et al. Predictive factor for intraoperative tumor rupture of Wilms tumor. Pediatr Surg Int 2017; 33: 91-95.
12.
Godziński J, Weirich A, Tournade MF, et al. Primary nephrectomy for emergency: a rare event in the International Society of Paediatric Oncology Nephroblastoma Trial and Study no. 9. Eur J Pediatr Surg 2001; 11: 36-39.
13.
Leape LL, Breslow NE, Bishop HC. The surgical treatment of Wilms’ tumor: results of the National Wilms’ Tumor Study. Ann Surg 1978; 187: 351-356.
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