Renal tumours of childhood – a review
Abstract
Renal tumours of childhood are rare, although they are one of the most common
solid tumours in children. They include numerous entities, which have different
clinical, histological, molecular biological and prognostic features, so their precise
diagnosis and staging are critical for appropriate treatment. The most common
is Wilms’ tumour (WT) with ~80-85 % of all cases, whereas other entities
including mesoblastic nephroma, clear cell sarcoma, rhabdoid tumour, renal
cell carcinoma, metanephric tumours and others are very rare (2-4 % each)
which explains why they represent a big diagnostic challenge for diagnostic pathologists.
They are subclassified into three risk groups – low, intermediate and
high – which have different treatments and prognosis. There are two big study
groups which have different approaches but remarkable similar outcomes. The
International Society of Paediatric Oncology approach (followed in most of the
world) is based on preoperative chemotherapy, followed by surgery and further
therapy, whereas the Children’s Oncology Group approach (followed mainly in
the United States and Canada) is based on primary surgery, followed by postoperative
treatment.
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