title: [Successful treatment of a case of advanced adult Wilms' tumor with pre-surgical chemotherapy, irradiation and radical nephrectomy].
abstract: A 37-year-old male was referred with a huge renal mass and multiple lung lesions. Abdominal and chest computed tomographic scan revealed a 11×15×17. 5 cm right renal tumor and multiple lung metastases. Neither tumor was enhanced, and no lymph adenopathy was detected. Percutaneous needle core biopsy was performed and the tumors were diagnosed as Wilms' tumor histologically supported by immunohistological positive staining to WT-1 and CD56. Since lung metastases were detected and the renal tumor reached the abdominal aorta on the left side, presurgical systemic chemotherapy (ifosphamide＋ carboplatin＋etoposide ; ICEx 4 courses) was performed. The renal tumor and the lung metastases were markedly decreased in size and subjected to a radical nephrectomy. Histological examination confirmed the diagnosis of Wilms' tumor without anaplastic change categorized as mesenchymal type. As an adjuvant therapy, irradiation to renal bed (40 Gy/20 fr) and bilateral lung (12 Gy/8 fr) were performed. Six months after the end of the therapy, no evidence of recurrence was detected.
authors.affiliation: The Department of Urology, Yamagata University, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamagishi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sakurai
authors.forename: Sei
authors.initials: S
authors.lastname: Naito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tsukigi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kato
authors.forename: Akira
authors.initials: A
authors.lastname: Nagaoka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Akiko
authors.initials: A
authors.lastname: Iwaba
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yamakawa
mesh_terms: D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D009392:Nephrectomy; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide