Renal carcinoma: bilateral breast metastases in a child

Malignant metastasis to the breast, rare in adults, has occurred in children from hematologic malignancies and from neuroblastoma and rhabdomyosarcoma. We report a case of bilateral breast metastases in a 14-year-old girl with a prior nephrectomy for renal cell carcinoma; the breast masses were the first sign of recurrence. Received: 25 March 1996 Accepted: 3 July 1996     

Bilateral cystic neuroblastoma: imaging features and differential diagnoses

Neuroblastoma is one of the most common malignant tumors of childhood, with 40 % arising in the adrenal glands. Bilateral adrenal involvement from synchronous development or metastatic spread of the tumor is seen in less than 10 % of children with neuroblastoma [1]. Neuroblastoma rarely presents as a cystic suprarenal mass that is difficult to differentiate from adrenal hemorrhage, extralobar sequestration, or dilated upper-pole renal calyces. To our knowledge, bilateral cystic neuroblastoma has not been previously reported. We present a case of bilateral cystic adrenal neuroblastoma to demonstrate the imaging features of this unusual entity, and to expand the differential diagnosis of bilateral cystic suprarenal masses in an infant. Received: 28 January 1997 Accepted: 28 March 1997     

Renal cell carcinoma in long-term survivors of advanced stage neuroblastoma in early childhood

BACKGROUND: Renal cell carcinoma (RCC) is rare in children and comprises only 1-3% of all pediatric primary renal tumors. Recently, several case reports have described RCC developing in patients previously treated for advanced stage neuroblastoma (NB). METHODS AND RESULTS: Our experience with four patients treated for advanced stage NB during early childhood who developed RCC later in life are added to 14 others in the literature. CONCLUSION: These patients and our review of the literature suggest an association between RCC and NB that warrants further study.     

Eosinophilic chromophobe renal cell carcinoma in a child with hypospadias

Chromophobe renal cell carcinoma (CRCC) is a distinct variant of renal carcinoma generally affecting adults. We report a case of an unusual CRCC, arising in a male child affected by hypospadias. This case demonstrates that CRCC can occur in the pediatric patients and can be associated with genital tract anomalies such as Wilms tumor.     

Undifferentiated Renal Cell Carcinoma in Infancy: Report of a Case and Review of Literature

A case of rapidly progressed undifferentiated renal cell carcinoma in a 2 2/12-month-old boy is reported. The histology is characterized by sarcomalike spindle and pleomorphic cells and bizarre giant cells, thus creating many difficulties in the differential diagnosis. The diagnosis of renal cell carcinoma was established on the basis of tubular formation by clear and granular cells observed in a few discrete areas.

The literature on renal cell carcinoma occurring under 10 years of age was reviewed, with special attention given to histological typing. It is general & believed that renal cell carcinoma in children is well differentiated, but 2 of 39 cases reviewed were undifferentiated. We conclude that renal cell carcinoma in infants or young children may have an undifferentiated, atypical histological appearance and can progress rapidly. The differential diagnosis from anaplastic Wilms' tumor and sarcomatous tumors of the kidney in children is discussed.     

Chromophobe renal cell carcinoma in a child: case report and review of the literature.

Renal cell carcinomas are rare in children but are in the differential diagnosis of renal masses in children age 5 years and older. We present a case of a chromophobe renal cell carcinoma in an 8-year-old boy that arose as a 7-cm (greatest dimension) unilateral renal mass. The tumor had eosinophilic cells, with the typical perinuclear halos and positive staining with Hale's colloidal iron that are seen in this tumor. Although papillary renal cell carcinomas are the most common variant of renal cell carcinoma in children, chromophobe renal cell carcinoma is a rarely reported variant that is not uncommon and has a relatively favorable prognosis in adults.     

Undifferentiated renal cell carcinoma in infancy: report of a case and review of literature

A case of rapidly progressed undifferentiated renal cell carcinoma in a 2 2/12-month-old boy is reported. The histology is characterized by sarcomalike spindle and pleomorphic cells and bizarre giant cells, thus creating many difficulties in the differential diagnosis. The diagnosis of renal cell carcinoma was established on the basis of tubular formation by clear and granular cells observed in a few discrete areas. The literature on renal cell carcinoma occurring under 10 years of age was reviewed, with special attention given to histological typing. It is generally believed that renal cell carcinoma in children is well differentiated, but 2 of 39 cases reviewed were undifferentiated. We conclude that renal cell carcinoma in infants or young children may have an undifferentiated, atypical histological appearance and can progress rapidly. The differential diagnosis from anaplastic Wilms' tumor and sarcomatous tumors of the kidney in children is discussed.     

Renal cell cancer in childhood]

Renal cell carcinoma is a rare disease in children and difficult to distinguish from Wilms-tumor before surgery. We present case histories of two children with renal cell carcinoma and discuss the problems of differential diagnosis versus nephroblastoma, therapy and prognosis. In contrast to Wilms-tumors, the most common kidney-tumor in children occurring mostly in young infants, renal cell carcinoma is rare in childhood and predominantly manifests in school-age. Only a few cases of renal cell carcinoma in younger children are described in the literature. Diagnostic imaging cannot reliably distinguish renal cell carcinoma from other neoplasm of the kidney. However, hematuria in patients with small tumors or no response to preoperative chemotherapy may indicate the presence of renal cell carcinoma rather than nephroblastoma. The determination of "tumor-associated trypsin inhibitor" (TATI) might give further contribution of differential diagnosis. It was measured only in one of our patients and was markedly elevated. Complete surgical resection (nephrectomy with lymphadenectomy) is a curative therapy in patients with tumors limited to the kidney. Chemotherapy and irradiation show no convincing effect. In metastatic tumors therapy with interleukin 2 may be successful.     

Renal cell carcinoma in children

Summary 2 cases of renal cell carcinoma in children were seen at JIPMER and General Hospital, Pondicherry, in the last 12 years. The first case came late with extensive metastases locally and to the liver, and after nephrectomy died soon with recurrence. The second case after nephrectomy is doing well for one year. Renal cell carcinoma should be considered in the differential diagnosis of renal tumours in children. The course and prognosis is very variable and seems to depend upon histological characteristics. From the departments of Surgery and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 6.     

Stage IV-S Neuroblastoma: Disseminated Malignancy With a Favourable Prognosis Three Case Reports

Stevens, M.M. (1979). Aust. Paediatr. J. , 15, 39–43. Stage IV-S neuroblastoma: disseminated malignancy with a favourable prognosis. Three cases reports. The case histories of three children with stage IV-S neuroblastoma are presented to illustrate the clinical features and unusual behaviour of this form of neuroblastoma. The staging requirements for this specific pattern of disease are presented and possible mechanisms of aetiology and regression and recommended management are discussed.     

Neuroblastoma with a fulminant clinical course caused by tumor embolism

The case of a 2 1/2-year-old girl with a well-nigh asymptomatic neuroblastoma of the left adrenal is described. In the final stage it gave rise to unusual clinical signs. The tumor had grown into the inferior vena cava via the left suprarenal and renal veins. Dissolution of the soft tumor mass in the vena cava caused fatal massive embolism of lungs and brain.     

Papillary renal cell carcinoma in a child.

AIM: To report a case of papillary renal cell carcinoma in a pediatric patient. METHOD: A seven-year-old boy complained of hematuria for one year. CT scan showed a mass in the middle zone of the right kidney. Radical nephrectomy was performed without incident. RESULT: Histology of the specimen showed papillary renal cell carcinoma. As the tumor was stage one, no chemotherapy was offered. At follow-up after 6 months the child was without recurrence or metastases. CONCLUSIONS: Papillary renal cell carcinoma is an uncommon kidney tumor in children and in its early stages it can be cured by nephrectomy alone.     

Neuroblastoma in a pair of identical twins

Hereditary neuroblastoma in a pair of identical twins is reported. In one of the twins the tumor occurred in fetal life and caused death of the twin before birth; in the other one, the tumor occurred at two months of life as IV-S neuroblastoma in the liver with primary tumor undetected. The unusual clinical course of the latter case is described: twice there was tumor regression, but in spite of treatment, fatal uncontrolled growth occurred. The family history, characterized by neoplasms of dissimilar cell types but without additional cases of neuroblastoma, is also detailed.     

Renal dysfunction and hyperuricemia at presentation and relapse of acute lymphoblastic leukemia

Hyperuricemia is an unusual presenting feature of acute lymphoblastic leukemia (ALL) and is generally associated with a large leukemic cell burden. We describe three children with T-cell ALL who presented with acute renal failure and very high serum uric acid concentrations, despite a relatively small leukemic cell burden. Two of the three patients had normal complete blood counts without circulating blasts or other physical evidence of leukemia. An isolated renal relapse in one case was associated with hyperuricemia, increased renal excretion of uric acid, and renal dysfunction. An unusually high rate of purine catabolism of the lymphoblasts may cause hyperuricemia in these cases. Unexplained hyperuricemia should prompt a search for occult malignancy.     

An unusual echographic evolution of an adrenal hematoma in a newborn infant

We report a case of adrenal hematoma whose ultrasound features ran an unusual course suggestive of a neuroblastoma. Surgical removal was finally performed at two months of age. We describe the unusual ultrasound features in this case and emphasize the value of ultrasonographic monitoring that is the only means for eliminating other diagnoses, particularly a neuroblastoma.     

Metastatic renal cell carcinoma in a child: 11-Year disease-Free survival following surgery

A child with metastatic renal cell carcinoma (RCC) is presented. This case is unusual in that the patient has remained disease free for 11 years following surgery and only one course of chemotherapy prior to thoracotomy. The management of metastatic RCC is reviewed and the genetic mechanisms leading to its development briefly discussed. Med. Pediatr. Oncol. 28:201–204 © 1997 Wiley-Liss, Inc.     

Renal cell carcinoma in children

Renal cell carcinoma is infrequent in children; consequently it is important to communicate its diagnosis and follow up. The behavior of this type of tumor is better characterized in adults and in this setting the treatment of choice is surgical resection. However, chemo- and radiotherapy for metastatic tumors has not been well defined. Our objective was to report the experience of a single pediatric institution in the diagnosis and treatment of renal cell carcinoma and to review the literature on this subject. We retrospectively reviewed patients diagnosed with renal cell carcinoma in the last twenty years. Only three patients were found, and we describe their clinical features and therapeutic approach. Although renal cell carcinoma is rare in children, clinical suspicion of this disease in children older than 5 years with renal masses is very important since the diagnostic and therapeutic approach differs from that for Wilms' tumor. The main prognostic factors seem to be staging and complete resection. Multicenter collaboration is required to standardize the treatment of tumors in advanced stages and to define the role of allogeneic stem cell transplantation in metastatic tumors.     

Phase I trial of trimetrexate in pediatric solid tumors: A pediatric oncology group study

Trimetrexate (TMTX), a lipophilic antifol, was evaluated in a Pediatric Oncology Group (POG) Phase I trial in children with refractory solid tumors. TMTX was administered intravenously daily × 5 every three weeks. Starting dose was 6.4 mg/m²/day. Dose was escalated by 20% until the maximal tolerated dose was reached. A total of 75 courses were administered to 26 children. The major toxicity was myelosuppression, of which neutropenia and thrombocytopenia were most prominent. Rash, mucositis, and transient liver enzyme elevations were infrequently seen. Responses were observed in children with brainstem glioma, neuroblastoma, and renal cell carcinoma. The recommended Phase II dose using this schedule is 9.2–11 mg/m²/day depending on how heavily the patient has been treated prior to initiating this therapy. © 1993 Wiley-Liss, Inc.     

Recurrent neuroblastoma with gastric invasion

The authors present an unusual manifestation of neuroblastoma in a young child: upper gastrointestinal bleeding due to erosion of the tumor into the stomach. Included are reviews of gastrointestinal manifestations of neuroblastoma and gastric tumors in children.     

儿童非肾母细胞瘤肾脏肿瘤的临床治疗探讨

目的总结和探讨儿童非。肾母细胞瘤肾脏肿瘤的治疗方法。方法1998年7月至2010年7月我们共收治非肾母细胞瘤肾脏肿瘤患儿18例,其中男性14例,女性4例,年龄最大9岁,最小2个月,平均年龄（40．17±34．04）个月,术后病理诊断包括肾透明细胞肉瘤9例（9／18,50％）,肾横纹肌样瘤2例（2／18,11．1％）,肾癌2例（2／18,10．1％）,肾中胚层。肾瘤1例（1／18,5．56％）,后。肾间质瘤1例（1／18,5．56％）,后肾腺瘤1例（1／18,5．56％）,肾血管平滑肌脂肪瘤1例（1／18,5．56％）,肾原始神经外胚叶瘤1例（1／18,5．56％）。结果随访9例肾透明细胞肉瘤,8（8／9）例无瘤生存,最长随访时间5年,最短2个月,平均随访时间（24．56±17．27）个月,1例手术化疗后下腔静脉瘤栓残留水平至右心房入口,放弃治疗1．5年后死亡。2例肾横纹肌样瘤经手术、放疗及化疗,随访3年和4年均无瘤存活。2例。肾癌单纯手术切除,密切随访25个月、13个月无复发及转移。1例。肾原始神经外胚叶瘤经手术及化疗,随访16个月无瘤存活。1例肾中胚层肾瘤、1例后。肾间质瘤、1例后。肾腺瘤、1例肾血管平滑肌脂肪瘤均完整切除,现最长随访时间4年,最短1年,无一例复发。结论儿童非肾母细胞瘤肾脏肿瘤所占比例虽小,但临床鉴别诊断困难,病理诊断非常重要,手术、化疗及放疗综合治疗是诊治的首要选择。