title: Multimodal treatment of advanced adult Wilms tumor.
abstract: We report 2 cases of advanced adult Wilms tumor that were treated with surgery, radiation and chemotherapy. The first patient had relapse of a Wilms tumor in the liver 2 years after nephrectomy. Combination chemotherapy, consisting of actinomycin D and vincristine, radiation therapy and final resection of the liver metastasis were successful and the patient has been free of disease for 4 years. The second patient had undergone transcatheter embolization of the renal artery elsewhere with the tentative diagnosis of an inoperable renal cell carcinoma metastatic to both lungs. A left renal tumor, weighing 4,500 gm., and a tumor thrombus in the vena cava extending to the right atrium were removed, and histologically diagnosed as a Wilms tumor. Subsequent chemotherapy and radiotherapy resulted in complete disappearance of the lung metastases. We conclude that multimodal treatment, namely a well timed combination of surgery, chemotherapy and radiotherapy, could potentially eradicate the disease even at an advanced stage.
mesh_terms: D000328:Adult; D003609:Dactinomycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy; D011879:Radiotherapy Dosage; D014750:Vincristine / Q000627:therapeutic use; D009396:Wilms Tumor / Q000556:secondary / Q000628:therapy*
chemical_list: D003609:Dactinomycin; D014750:Vincristine