title: Fatty degeneration in a Wilms' tumour after chemotherapy.
abstract: We report a case of extensive fatty change in a Wilms' tumour after chemotherapy demonstrated on CT associated with an increase in tumour volume, in a 10-month-old girl with Beckwith-Wiedemann syndrome. Changes in tumour characteristics after chemotherapy on imaging usually reflect necrosis, haemorrhage and calcification. Assessment of response to therapy is dependent on a documented reduction in tumour volume. In this case, CT showed an increase in tumour size with development of an extensive fatty component following treatment. Subsequent histological examination on the nephrectomy specimen confirmed an extensive fatty component with no evidence of residual blastema. The development of such an extensive fatty component is very unusual. In this case such fatty change was an indicator of tumour sensitivity and response to treatment.
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. jeanea@gosh.nhs.uk
authors.forename: A C
authors.initials: AC
authors.lastname: Jeanes
authors.forename: R C
authors.initials: RC
authors.lastname: Beese
authors.forename: K
authors.initials: K
authors.lastname: McHugh
authors.forename: A D
authors.initials: AD
authors.lastname: Ramsay
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D001506:Beckwith-Wiedemann Syndrome / Q000378:metabolism / Q000601:surgery; D006348:Cardiac Surgical Procedures; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000378:metabolism / Q000601:surgery; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000601:surgery; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000188:drug therapy* / Q000378:metabolism* / Q000601:surgery
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin