EMBRYOMA OF KIDNEY (WILMS' TUMOR) IN CHILDREN

Abstract

A series of 12 cases of Wilms' tumor, in which the diagnosis was confirmed in all instances by examination of the gross or microscopic tissue, is reported, with a survival rate of 33.3%. Four patients are living and well, 4, 8, 10, and 15 years, respectively, after treatment. All recurrences appeared less than 10 months after treatment. The sex incidence, and the sex survival incidence were exactly equal. Six tumors were in the left kidney, and six in the right. Eight of the patients were under 2 years of age when first diagnosed and treated, and all were under 7 years. The history of breast or bottle feeding was irrelevant. In a large number of these and reported cases, the presence of the tumor was the first symptom, and in a considerable number the only symptom. This fact stresses the importance of careful physical examination of infants and young children, regardless of complaint, or of lack of it. The finding of calcification in the tumor is possibly a good prognostic sign. All three patients in whom calcification was noted in the tumor are living and well. Immediate removal of the tumor by transperitoneal nephrectomy, with postoperative radiation to the area, seems to be the advisable treatment.