Serum creatine kinase levels parallel the clinical course for rhabdomyomatous Wilms tumor.
A right-sided renal mass in an 11-month-old girl was diagnosed by percutaneous needle biopsy as Wilms tumor, which on histologic examination was found to be predominantly rhabdomyomatous. As part of the examination, serum creatine kinase (CK) and CK-MB levels were measured and were significantly elevated at 994 U/L (reference range, 42-180 U/L) and 40 U/L (reference range, 0-3 U/L), respectively. Subsequently, an 8-month-old girl was admitted to the hospital with septicemia and was found to have an abdominal mass. A diagnosis of bilateral Wilms tumor was made following percutaneous biopsy of both kidneys; histologic examination confirmed that the tumor was predominantly rhabdomyomatous. Serum CK and CK-MB levels also were measured and were significantly elevated at 685 U/L and 84.4 U/L, respectively. In both cases, the serum CK and CK-MB levels reflected the clinical course; elevation in serum levels was associated with tumor recurrence, infarction, or chemotherapy-related necrosis. We conclude that these enzymes have clinical usefulness as markers for Wilms tumor showing rhabdomyomatous morphologic features.
Delahunt
B
B
Dept of Pathology and Molecular Medicine, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand.
Lewis
M E
ME
Pringle
K C
KC
Wiltshire
E J
EJ
Crooke
M J
MJ
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood*; D003609:Dactinomycin / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007223:Infant; D007680:Kidney Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy; D015080:Mesna / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009392:Nephrectomy; D012015:Reference Standards; D012207:Rhabdomyoma / Q000097:blood* / Q000473:pathology / Q000628:therapy; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000097:blood* / Q000473:pathology / Q000628:therapy
D014408:Biomarkers, Tumor; D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003402:Creatine Kinase; D015080:Mesna; D007069:Ifosfamide