Gutjahr P
Universitätsklinik Mainz.
Geburtshilfe Frauenheilkd. 1991 Feb;51(2):124-6. doi: 10.1055/s-2007-1023687.
In a nationwide study (1980-1988) for the diagnosis and treatment of Wilms' tumours (nephroblastomas), which are highly malignant embryonal mixed tumours of the kidney and show distant metastases at the time of diagnosis in 10-20% of cases, 78% of 373 children had a standard type Wilms' tumour, 7% had benign variants and 14% had high grade malignancy variants of the classical type. 20 of the 25 benign variants occurred in infants. From the 25, 16 tumours were congenital mesoblastic nephromas, 14 of which occurred in infants. As the detection of a solid renal tumour mass in the prenatal sonogram (showing an echotexture resembling that of the liver) may suggest Wilms' tumour, we analysed 11 neonates (1-14 days old), in which Wilms' tumours had been diagnosed (n = 11; 2.9%) for the histological subtype. In 9 of the 10 neonates, the final diagnosis was congenital mesoblastic nephroma. These congenital mesoblastic nephromas are cured by surgery alone. Thus, if a solid renal tumour suspected as a Wilms' tumour, is prenatally detected, the most probable diagnosis is that of the benign variant congenital mesoblastic nephroma, and, in this case, preterm delivery (e.g. to prevent metastasising and to start treatment as early as possible) is not indicated.
在一项针对肾母细胞瘤（肾胚胎瘤）诊断和治疗的全国性研究（1980 - 1988年）中，肾母细胞瘤是一种高度恶性的肾脏胚胎性混合肿瘤，10% - 20%的病例在诊断时已有远处转移。373名儿童中，78%患有标准型肾母细胞瘤，7%患有良性变异型，14%患有经典型的高级别恶性变异型。25例良性变异型中有20例发生在婴儿期。在这25例中，16例肿瘤为先天性中胚层肾瘤，其中14例发生在婴儿期。由于产前超声检查中发现实性肾肿瘤肿块（其回声纹理类似于肝脏）可能提示肾母细胞瘤，我们分析了11例已诊断为肾母细胞瘤的新生儿（1 - 14日龄）（n = 11；2.9%）的组织学亚型。10例新生儿中有9例最终诊断为先天性中胚层肾瘤。这些先天性中胚层肾瘤仅通过手术即可治愈。因此，如果产前检测到疑似肾母细胞瘤的实性肾肿瘤，最可能的诊断是良性变异型先天性中胚层肾瘤，在这种情况下，不建议早产（例如，以防止转移并尽早开始治疗）。
