Renal tumors and tumor-like lesions in pediatric patients

John M. Kissane, Louis P. Dehner

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

Abstract

Renal enlargement presenting as an abdominal mass(es) is attended by a lengthly differential diagnosis of non-neoplastic and neoplastic lesions with a range in serious connotations and consequences. Simple compensatory hypertrophy and unilateral multicystic dysplasia are relatively innocuous and easily recognized with appropriate imaging studies; they are also related in the sense that the normal contralateral kidney hypertrophies in the absence of a non-functioning dysplastic kidney. Bilateral nephromegaly in a neonate is generally a sign of autosomal recessive polycystic kidney disease or multicystic dysplasia secondary to distal obstructive uropathy. Primary neoplasms of kidney in the pediatric population in the past were traditionally classified as Wilms' tumors, but that erroneous practice has been eliminated with the recognition of several distinctive neoplasms in addition to classic Wilms' tumor. Separating a typical Wilms' tumor from mesoblastic nephroma, clear cell sarcoma of the kidney and the malignant rhabdoid tumor, for treatment and prognostic purposes, has become the accepted norm in the past 12-13 years. Another important advance at the cellular level is the recognition of a deletion in the short arm of chromosome 11 in the cultured cells of Wilms' tumor and in the germ cell line in certain clinical settings of Wilms' tumors. A dramatic expansion in the understanding and management of childhood renal neoplasms has occurred through the multimodality approach of laboratory investigation and applied clinical research.

Original languageEnglish
Pages (from-to)365-382
Number of pages18
JournalPediatric Nephrology
Volume6
Issue number4
DOIs
StatePublished - Jul 1 1992

Keywords

  • Aniridia
  • Chromosome 11
  • Clear cell sarcoma of kidney
  • Malignant rhabdoid tumor
  • Mesoblastic nephroma
  • Nephroblastomatosis
  • Wilms' tumor

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