Hughson M D, Hennigar G R, Othersen H B
Am J Clin Pathol. 1976 Aug;66(2):376-89. doi: 10.1093/ajcp/66.2.376.
The most common differentiated renal tumor of early childhood is the congenital mesoblastic neophroma. Well-differentiated forms of Wilms' tumor may present a difficult differential diagnosis from these benign neoplasms. The cases of two patients found to have well-differentiated renal neoplasms after being treated for Wilms' tumor of the opposite kidneys are reported. The second neoplasms were composed of a benign-appearing stroma with mature skeletal muscle and completely lacked any embryonal, nephroblastic tissue. These benign-appearing neoplasms may be cytodifferentiated variants of Wilms' tumor. Though tumors of this type may have a malignant potential, there is evidence to indicate that they may be approached more conservatively than the usual nephroblastoma. In cases of bilateral Wilms' tumor, well-differentiated tumors might be treated by partial nephrectomy alone, with careful preservation of functional renal tissue.
儿童早期最常见的分化型肾肿瘤是先天性中胚层肾瘤。高分化型威尔姆斯瘤可能难以与这些良性肿瘤进行鉴别诊断。本文报告了两名患者的病例，他们在接受对侧肾脏威尔姆斯瘤治疗后被发现患有高分化肾肿瘤。第二种肿瘤由外观良性的间质组成，伴有成熟骨骼肌，完全缺乏任何胚胎性、肾母细胞性组织。这些外观良性的肿瘤可能是威尔姆斯瘤的细胞分化变异型。尽管这类肿瘤可能具有恶性潜能，但有证据表明，与通常的肾母细胞瘤相比，它们的治疗方式可能更为保守。在双侧威尔姆斯瘤的病例中，高分化肿瘤可能仅通过部分肾切除术进行治疗，并小心保留功能性肾组织。
