Pediatric Surgery International

, Volume 26, Issue 4, pp 349–353 | Cite as

Spinal cord compression in children with Wilms’ tumour

Original Article

Abstract

Purpose

To document the clinical, imaging and histopathological features of five children with paraplegia due to Wilms’ tumour (WT), highlighting therapeutic options and patient outcome in a developing country.

Methods

Patients with WT and paraplegia seen at the Department of Paediatric Surgery since 1984 form the study cohort. Patient demographics, duration of neurological symptoms, stage of primary tumour, therapeutic intervention and outcome were recorded. Histology of the primary tumours and paraspinal or epidural biopsies were reviewed.

Results

Five patients with WT and paraplegia were identified. Imaging showed epidural masses with paraspinal disease, cord displacement and compression. Four patients have died. Of the two patients with neurological recovery, one relapsed 4 months later. Histology revealed triphasic WT with one case showing anaplasia. Paraspinal or epidural biopsies confirmed WT with post-treatment changes. Three biopsies showed lymphovascular, perineurial and intraneural tumour invasion and one showed epidural venous invasion.

Conclusion

Although rare, WT-associated spinal disease may cause permanent neurological deficit, adding considerably to the burden of disease. In developing countries where patients present late, the prognosis is poor, however surgery may provide immediate relief of compression symptoms and biopsy material. The treatment of choice will depend on the facilities available and the clinical circumstances.

Keywords

Wilms’ tumour Nephroblastoma Paraplegia Spinal Compression 

Notes

Acknowledgments

The authors are grateful to Mrs M. Moodley for literature retrieval, manuscript typing and formatting, Ms E. Connor for clinical data management, Mr C. Sydney and D. Sookhdeo for laboratory support and literature retrieval.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of Anatomical Pathology, Nelson R Mandela School of MedicineUniversity of KwaZulu Natal, National Health Laboratory ServiceDurbanSouth Africa
  2. 2.Department of Paediatric Surgery, Nelson R Mandela School of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa

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