van Peer Sophie E, Pleijte Corine J H, de Krijger Ronald R, Jongmans Marjolijn C J, Kuiper Roland P, Lilien Marc R, van Grotel Martine, Graf Norbert, van den Heuvel-Eibrink Marry M, Hol Janna A
Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.
Department of Pathology, University Medical Center Utrecht (UMCU), 3584 CX Utrecht, The Netherlands.
Cancers (Basel). 2021 Feb 27;13(5):997. doi: 10.3390/cancers13050997.
In children presenting with a predominantly cystic renal tumor, the most likely diagnoses include cystic partially differentiated nephroblastoma (CPDN) and cystic nephroma (CN). Both entities are rare and limited information on the clinical and molecular characteristics, treatment, and outcome is available since large cohort studies are lacking. We performed an extensive literature review, in which we identified 113 CPDN and 167 CN. The median age at presentation for CPDN and CN was 12 months (range: 3 weeks-4 years) and 16 months (prenatal diagnosis-16 years), respectively. No patients presented with metastatic disease. Bilateral disease occurred in both entities. Surgery was the main treatment for both. Two/113 CPDN patients and 26/167 CN patients had previous, concomitant, or subsequent other tumors. Unlike CPDN, CN was strongly associated with somatic ( = 27/29) and germline ( = 12/12) -mutations. Four CPDN patients and one CN patient relapsed. Death was reported in six/103 patients with CPDN and six/118 CN patients, none directly due to disease. In conclusion, children with CPDN and CN are young, do not present with metastases, and have an excellent outcome. Awareness of concomitant or subsequent tumors and genetic testing is important. International registration of cystic renal tumor cohorts is required to enable a better understanding of clinical and genetic characteristics.
在以肾囊性肿瘤为主的儿童中,最可能的诊断包括囊性部分分化型肾母细胞瘤(CPDN)和囊性肾瘤(CN)。这两种实体瘤均很罕见,由于缺乏大型队列研究,关于其临床和分子特征、治疗及预后的信息有限。我们进行了广泛的文献综述,从中确定了113例CPDN和167例CN。CPDN和CN的中位发病年龄分别为12个月(范围:3周 - 4岁)和16个月(产前诊断 - 16岁)。没有患者出现转移性疾病。双侧病变在这两种实体瘤中均有发生。手术是两者的主要治疗方法。113例CPDN患者中有2例、167例CN患者中有26例曾有过、同时患有或随后患有其他肿瘤。与CPDN不同,CN与体细胞( = 27/29)和种系( = 12/12)突变密切相关。4例CPDN患者和1例CN患者复发。103例CPDN患者中有6例、118例CN患者中有6例报告死亡,均非直接死于疾病。总之,患有CPDN和CN的儿童年龄较小,无转移表现,预后良好。认识到伴随或后续发生的肿瘤以及进行基因检测很重要。需要对肾囊性肿瘤队列进行国际登记,以便更好地了解临床和遗传特征。