Extrarenal nephroblastic proliferation in spinal dysraphism. A report of 4 cases

Ectopic immature renal tissue presenting as a pedunculated sacral mass in a neonate

Ectopic immature renal tissue (EIRT) has been reported in a variety of tissues of mesodermal origin, including the dermis of the skin. We report a case of a newborn with a congenital lumbosacral mass with pathologic findings consistent with EIRT. This report highlights the clinical and pathologic considerations of EIRT, including associations with spinal dysraphism, teratoma, and Wilm's tumor.

Ectopic Immature Renal Tissue Associated with Lipomeningomyelocele and Enteric Duplication Cyst: A Report of Two Cases

Ectopic immature renal tissue (EIRT) is a lesion rarely described in the literature. It shows the components of a nephrogenic rest including the blastema, epithelia, and stroma. We report two cases of EIRT in a 3-year-old female and an 8 months male child, associated with lipomeningomyelocele and an enteric duplication cyst, respectively, along with detailed immunohistochemical profile. Though there are a few cases of EIRT associated with teratoma, only two cases of EIRT associated with lipomeningomyelocele have been described in the English literature. Moreover, extensive literature search did not reveal any previous case report where EIRT had been documented in an enteric duplication cyst.

Extrarenal nephroblastomatosis in children: a report of two cases

BACKGROUND

Extrarenal nephroblastomatosis is a rare entity which occurs in retroperitoneum and inguinal region predominantly. Here we report two cases of primary extrarenal nephroblastomatosis of Han Chinese in Asian in unusual locations, one is located in testis and paratestis, and the other is paraspinal cord.

CASE PRESENTATION

Patient 1 was a 19-month-old boy with a hard and nodular mass adherent to the left testis in inguinal region. Patient 2 was a 9-month-old boy with a 1 × 0.7 × 0.4 cm mass in spinal canal at the midline thoracolumbar region. Histological examinations of the two patients after operations revealed extrarenall nephroblastomatosis with multiple nephrogenic foci, composed of immature glomeruli, tubules and blastemal cells.Then the patients were closely monitored without adjuvant chemotherapy, and has been alive and well without any recurrence for >6 months.

CONCLUSIONS

Most nephrogenic rests remain subclinical, and thus, complete excision of the lesion with conservative treatment is recommended. Otherwise, nephrogenic rests are close associated with Wilms tumor and regular follow-up is required to ensure early detection of malignant transformation.

Extrarenal Wilms tumor: a case report and review of the literature

Extrarenal Wilms tumors are extremely rare with only isolated case reports in the pediatric literature. We present the case of a 2-year old boy who presented with a large abdominal mass and constipation. Pathologic diagnosis of the tumor was extrarenal Wilms tumor (ERWT) with favorable histology. We discuss the diagnostic workup, radiologic and operative findings, treatment and review of the literature.

Pelvic Wilms tumor in a child with an absent right kidney and spinal malformations

Wilms tumor rarely occurs in other sites outside the kidney. Various congenital malformations often accompany Wilms tumor, but spinal deformations are rarely seen. We report a very rare association of multiple spinal malformations, right kidney absence, and pelvic Wilms tumor in a 21-month-old girl. The report includes a brief review of relevant literature.

Wilms tumor arising in extracoelomic paravertebral soft tissues

Extrarenal Wilms tumor (ERWT) is a well-established entity which most commonly arises within the genitourinary tract, including intracoelomic paranephric soft tissue. Rarely, ERWT arises within teratoma, and it tends to occur predominantly in distinct settings, such as females with spinal defects and males with testicular teratomas. We report a unique ERWT arising within an extracoelomic teratoma of the paraspinal musculature, thereby expanding the range of reported locations for this unusual tumor.

Spinal cord nephroblastoma in dogs: 11 cases (1985-2007)

OBJECTIVE

To evaluate clinical features and outcome of dogs with a confirmed spinal cord nephroblastoma and to describe the use of Wilms tumor-1 (WT-1) immunohistochemical staining to confirm a diagnosis of nephroblastoma in dogs.

DESIGN

Retrospective case series. Animals-11 dogs with a spinal cord nephroblastoma.

PROCEDURES

Medical records of dogs with a spinal cord nephroblastoma were reviewed. Information extracted included signalment, history, clinical signs, results of diagnostic testing, tumor location, treatment, and outcome. The diagnosis was confirmed through histologic review and WT-1 immunohistochemical staining of a tumor sample. In dogs with negative results for staining with WT-1, staining for cytokeratin, vimentin, and glial fibrillar acidic protein was performed.

RESULTS

11 dogs had a spinal cord tumor with a histologic appearance and immunohistochemical staining consistent with a nephroblastoma. Positive results for staining with WT-1 were detected in 9 of 11 dogs. Age at admission ranged from 5 to 48 months (median, 14 months). Nine dogs were female. All had progressive paraparesis, paraplegia, or ataxia. Duration of clinical signs ranged from 2 to 60 days (median, 14 days). Median survival time was 30 days from the time of diagnosis. Median survival time in dogs treated via surgical resection was 70.5 days.

CONCLUSIONS AND CLINICAL RELEVANCE

The prognosis for dogs with a spinal cord nephroblastoma appeared to be poor, although combined surgical resection and radiation therapy may provide a good functional outcome. Results for staining with WT-1 can be used to support a diagnosis of nephroblastoma.

Wilms' tumor associated with vertebral anomalies

The association of Wilms tumor (WT) and vertebral disorders, such as hemivertebrae or fusion anomalies, have been described in literature. Here, we report a rare association of butterfly T3, T8 vertebrae and a T2, T7 hemivertebrae in a patient with WT, determined during initial examinations of tumoral extension. In patients with WT, investigation of vertebral malformations should be a part of diagnostic work-up.

Primary lumbosacral Wilms tumor associated with diastematomyelia and occult spinal dysraphism. A report of a rare case and a short review of literature

BACKGROUND

The occurrence of an extrarenal Wilms tumor in the lumbosacral region is an extremely uncommon condition.

CASE REPORT

We report a case of Wilms tumor in the lumbosacral region that was associated with diastematomyelia and occult spina bifida. An 18-month-old girl presented with a swelling over the lower back with a tuft of hair on it, which she had had since birth. Imaging of the spine revealed spina bifida, bony diastematomyelia, and tethered cord. Excision of the bony spur and detethering of the cord was done. After a year, she had recurrence of swelling at the same site, weakness of both lower limbs, and incontinence of bladder and bowel. Excision of the mass and bony spur and detethering of the spinal cord were done. Histopathological examination showed features of a Wilms tumor.