title: Laparoscopic nephron-sparing resection of synchronous Wilms tumors in a case of hyperplastic perilobar nephroblastomatosis.
abstract: Diffuse hyperplastic perilobar nephroblastomatosis (DHPLN) is a rare precursor lesion of Wilms tumor (WT). Because of the increased risk to develop WT in either kidney, current management algorithms of DHPLN merit nephron-sparing strategies, beginning with chemotherapy and close radiographic monitoring into late childhood. After resolution of DHPLN, subsequent detection of a renal nodule mandates resection to exclude WT. Here, we report the case of a 4-year-old girl who developed 2 synchronous nodules in the right kidney more than 2 years after completion of therapy for DHPLN. Because of the early detection and peripheral location of these 2 nodules, laparoscopic nephron-sparing resection of each was performed using ultrasonic dissection. Both nodules were determined on pathology to be favorable histology WT with negative surgical margins. The child was placed on vincristine and actinomycin D therapy for 18 weeks.
authors: Department of Pediatric Surgery, Vanderbilt University School of Medicine, Monroe Carrel, Jr. Children's Hospital, Nashville, TN, USA.
authors: Thomas P
authors: TP
authors: Rauth
authors: Jeremy
authors: J
authors: Slone
authors: Gabriella
authors: G
authors: Crane
authors: Hernan
authors: H
authors: Correa
authors: Debra L
authors: DL
authors: Friedman
authors: Harold N
authors: HN
authors: Lovvorn
references: Curr Opin Urol. 2011 Jan;21(1):60-4
references: 20962648
references: Pediatr Pathol. 1990;10(1-2):1-36
references: 2156243
references: Am J Med Genet. 1998 Oct 2;79(4):268-73
references: 9781906
references: Pediatr Blood Cancer. 2006 Feb;46(2):203-21
references: 15816029
references: Arch Surg. 2001 Aug;136(8):897-907
references: 11485525
references: J Pediatr Hematol Oncol. 2010 Aug;32(6):489-93
references: 20539237
references: Lancet Oncol. 2004 Jan;5(1):37-46
references: 14700607
references: J Urol. 2007 Oct;178(4 Pt 2):1786-9; discussion 1789-90
references: 17707428
references: Oncologist. 2005 Nov-Dec;10(10):815-26
references: 16314292
references: Neoplasia. 2007 Jul;9(7):589-600
references: 17710162
references: Adv Anat Pathol. 2001 Sep;8(5):276-89
references: 11556536
references: J Urol. 2004 Oct;172(4 Pt 1):1438-40
references: 15371863
references: J Pediatr Surg. 2008 Nov;43(11):1982-4
references: 18970928
references: Surg Laparosc Endosc Percutan Tech. 2009 Apr;19(2):148-52
references: 19390283
references: Curr Opin Urol. 2010 Sep;20(5):365-70
references: 20644483
references: Cancer. 2008 May 1;112(9):2060-70
references: 18361398
references: Med Pediatr Oncol. 1993;21(3):158-68
references: 8383276
references: Expert Rev Anticancer Ther. 2009 Jun;9(6):753-61
references: 19496712