Faizan Mahwish, Sultana Nighat, Anwar Sadia, Mehmood Qaiser, Ali Agha Shabbir
Department of Paediatric Hematology-Oncology, The Children'sHospital and ICH, Lahore.
Department of Paediatric Intensive Care Unit, The Children'sHospital and ICH, Lahore.
J Coll Physicians Surg Pak. 2015 Apr;25 Suppl 1:S41-2.
Abdominal masses in children are usually retroperitoneal in location and 50% are renal in origin. In infants less than 2 months, majority of renal masses are benign; frequency of malignancy increases with age. Wilms'tumor is the commonest solid intrarenal tumors. However, occasionally neuroblastoma occurs in the kidney. Neuroblastoma in 50% of cases presents before 2 years of age, and 75% before 4 years. Neuroblastomas can occur anywhere along the neuroectodermal sympathetic chain, although adrenal medulla is the commonest site (50 - 70%). Intrarenal neuroblastoma is a rare clinical diagnosis. It clinically and radiologically mimics Wilms'tumor and it is difficult to differentiate between the two preoperatively. Lung metastasis and vascular invasion are also rare in neuroblastoma but rather common in Wilms'tumor. We present case of a patient who had extensive renal involvement with neuroblastoma and pulmonary metastasis, clinically and radiologically it was difficult to differentiate between the Wilms'tumor and neuroblastoma.
儿童腹部肿块通常位于腹膜后，其中50%起源于肾脏。在2个月以下的婴儿中，大多数肾脏肿块是良性的；恶性肿瘤的发生率随年龄增长而增加。肾母细胞瘤是最常见的肾实质内肿瘤。然而，偶尔也会在肾脏中发生神经母细胞瘤。50%的神经母细胞瘤病例在2岁前出现，75%在4岁前出现。神经母细胞瘤可发生于神经外胚层交感神经链的任何部位，尽管肾上腺髓质是最常见的部位（50%-70%）。肾内神经母细胞瘤是一种罕见的临床诊断。它在临床和放射学上与肾母细胞瘤相似，术前很难区分两者。神经母细胞瘤的肺转移和血管侵犯也很少见，但在肾母细胞瘤中相当常见。我们报告一例患有广泛肾受累及肺转移的神经母细胞瘤患者，在临床和放射学上很难区分肾母细胞瘤和神经母细胞瘤。
