Hentrich M U, Meister P, Brack N G, Lutz L L, Hartenstein R C
Department of Medicine IV, Munich Harlaching City Hospital, Germany.
Cancer. 1995 Jan 15;75(2):545-51. doi: 10.1002/1097-0142(19950115)75:2<545::aid-cncr2820750218>3.0.co;2-c.
Wilms' tumor is rare in adults. The recommended treatments for patients with Stage II adult Wilms' tumor with favorable histology (FH) nephroblastomas are conflicting.
Two patients with Stage II, favorable histology, adult nephroblastomas are described. Current treatment modalities are discussed and the literature is reviewed.
The first patient, a 52-year-old woman, probably had a late local relapse of a Wilms' tumor 21 years after nephrectomy because of a renal tumor originally diagnosed as reticular sarcoma. In this case, a recurring or an extrarenal Wilms' tumor should have been considered. After the tumor was removed, the patient received adjuvant chemotherapy with dactinomycin and vincristine and was disease free 44 months after diagnosis. The Wilms' tumor in the second patient, a 33-year-old woman, was discovered accidentally and classified as Stage II/FH based on preoperative biopsy. She was treated with radical nephrectomy and adjuvant chemotherapy with dactinomycin and vincristine. This patient was disease free 24 months after surgery.
Surgery and two-drug chemotherapy with dactinomycin and vincristine is suggested for patients with Stage II adult Wilms' tumor with FH nephroblastomas.
成人肾母细胞瘤较为罕见。对于组织学类型良好（FH）的II期成人肾母细胞瘤患者，推荐的治疗方法存在争议。
描述了2例II期、组织学类型良好的成人肾母细胞瘤患者。讨论了当前的治疗方式并回顾了相关文献。
首例患者为一名52岁女性，因最初诊断为网状肉瘤的肾肿瘤行肾切除术后21年，可能发生了肾母细胞瘤的局部晚期复发。在这种情况下，应考虑复发性或肾外肾母细胞瘤。肿瘤切除后，患者接受了放线菌素D和长春新碱辅助化疗，诊断后44个月无疾病复发。第二例患者为一名33岁女性，偶然发现肾母细胞瘤，根据术前活检分类为II期/FH。她接受了根治性肾切除术及放线菌素D和长春新碱辅助化疗。该患者术后24个月无疾病复发。
对于组织学类型良好的II期成人肾母细胞瘤患者，建议采用手术及放线菌素D和长春新碱两药联合化疗。
