Crombleholme T M, Jacir N N, Rosenfield C G, Lew S, Harris B H
Department of Pediatric Surgery, Tufts University School of Medicine, Boston Floating Hospital, MA 02111.
J Pediatr Surg. 1994 Feb;29(2):229-31. doi: 10.1016/0022-3468(94)90323-9.
Extension of Wilms' tumor into the renal vein and vena cava complicates the operative treatment of a small but significant number of patients. Two children presented with Wilms' tumor and intracaval tumor extension. After biopsy, both children were given chemotherapy. In one case the tumor completely disappeared from the vena cava, and in the other the tumor regressed substantially, and proximal control became possible at the level of the infrahepatic vena cava. Both children then had an uneventful nephrectomy that was greatly simplified. We conclude that preoperative chemotherapy can induce resolution of intravascular tumor, and may be a useful option in cases of extension of Wilms' tumor into the vena cava.
肾母细胞瘤延伸至肾静脉和腔静脉会使一小部分但数量可观的患者的手术治疗变得复杂。两名患有肾母细胞瘤并伴有腔静脉内肿瘤延伸的儿童。活检后，两名儿童均接受了化疗。其中一例肿瘤从腔静脉完全消失，另一例肿瘤大幅消退，从而能够在肝下腔静脉水平进行近端控制。两名儿童随后均顺利进行了肾切除术，手术大为简化。我们得出结论，术前化疗可促使血管内肿瘤消退，对于肾母细胞瘤延伸至腔静脉的病例可能是一种有用的选择。
