Yanai Toshihiro, Okazaki Tadaharu, Yamataka Atsuyuki, Kobayashi Hiroyuki, Lane Geoffrey J, Saito Masahiro, Fujita Hiroo, Yamashiro Yuuichiro, Miyano Takeshi
Department of Pediatric Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, 113-8421 Bunkyo-ku, Tokyo, Japan.
Pediatr Surg Int. 2005 Jan;21(1):43-6. doi: 10.1007/s00383-004-1261-0.
We report two rare cases of botryoid Wilms' tumor (BWT) occupying the renal collecting system with no macroscopic parenchymal mass. In case 1, a 3-year-old boy presented with a mass in the right flank, low-grade fever, abdominal pain, and macrohematuria. Radiology revealed an enlarged right kidney with a heterogeneous mass occupying a large part of the dilated renal calyx, pelvis, and ureter. Radical right nephroureterectomy was performed. The histopathologic diagnosis was nephroblastoma, and the pedicle of the tumor was attached to the renal parenchyma near the pelvic wall. In case 2, a 2-year-old boy presented with macrohematuria, and the clinical course was almost the same as in case 1. No local recurrence or metastatic spread has been detected for 4 years postoperatively in case 1 and for 9 months postoperatively in case 2.
我们报告了两例罕见的葡萄状威尔姆斯瘤(BWT),肿瘤占据肾集合系统,无肉眼可见的实质肿块。病例1为一名3岁男孩,表现为右侧腰部肿块、低热、腹痛和肉眼血尿。影像学检查显示右肾增大,有一不均匀肿块占据大部分扩张的肾盏、肾盂和输尿管。行右侧根治性肾输尿管切除术。组织病理学诊断为肾母细胞瘤,肿瘤蒂附着于盆腔壁附近的肾实质。病例2为一名2岁男孩,表现为肉眼血尿,临床过程与病例1几乎相同。病例1术后4年及病例2术后9个月均未检测到局部复发或转移扩散。