Lamalmi N, Rouas L, Cherradi N, Malihy A, Khattab M, Alhamany Z
Hôpital d'Enfants, Rabat, Maroc.
Arch Pediatr. 2010 Dec;17(12):1664-6. doi: 10.1016/j.arcped.2010.08.031. Epub 2010 Oct 12.
We report on a rare case of botryoid Wilms tumor extending into the duodenum. This uncommon macroscopic form of nephroblastoma consists entirely of a polypoid renal intrapelvic mass. The main differential diagnosis of this unusual tumor is botryoid rhabdomyosarcoma. A 14-month-old boy presented with a painful abdominal mass. Radiology revealed a large heterogeneous mass in the renal calyx, protruding into the ureter. A right radical nephroureterectomy was carried out. The tumor was found to extend into the 2nd portion of the duodenum. The pathologic diagnosis was mixed type nephroblastoma, SIOP 2001 stage III. The patient was given a course of postoperative chemotherapy. No local recurrence or metastatic spread has been detected after 2 years. Only few such cases have been previously reported, some of them extending into the bladder. To our knowledge, botryoid nephroblastoma has not previously been described as extending into the digestive system.
我们报告了一例罕见的葡萄状威尔姆斯瘤延伸至十二指肠的病例。这种肾母细胞瘤不常见的大体形态完全由息肉样肾盂内肿块组成。这种不寻常肿瘤的主要鉴别诊断是葡萄状横纹肌肉瘤。一名14个月大的男孩因腹部疼痛性肿块就诊。影像学检查显示肾盏内有一个大的不均匀肿块,突出至输尿管。进行了右侧根治性肾输尿管切除术。发现肿瘤延伸至十二指肠第二部。病理诊断为混合型肾母细胞瘤,国际小儿肿瘤学会(SIOP)2001分期III期。患者接受了一个疗程的术后化疗。2年后未检测到局部复发或转移扩散。此前仅报道过少数此类病例,其中一些延伸至膀胱。据我们所知,此前尚未有葡萄状肾母细胞瘤延伸至消化系统的描述。