Case Report

Perilobar Nephroblastomatosis: Natural History and Management

Table 1

Cases with initial diagnosis of NB (NB) without synchronous WT published since 1990.

CaseReferenceAge at
diagnosis
SexDiagnosisClinical presentation at diagnosisCongenital defectsBiopsy
for NB
Ch for NB/
duration
Response to
initial Ch
Srg
For
NB
Ra
For
NB
Development
of WT
Outcome/
follow-up since initial diagnosis

1Gaulier et al., Pediatr Pathol., 1993 [8]NewbornUnilateral universal
NB
Cystic renal process discovered prenatallyYesYesNoYesNoNoAlive/1 yr

2Regalado et al., Pediatr Pathol.,1994 [9]NewbornMBilateral universal
NB
Potter's-like facies, hypoplastic lungs, ascites, and bilateral nephromegalyYesYes (postmortem)NoNoNoNoDead at age of
21 h

3 Verloes et al., Clin Genet., 1995 [10]Newborn Bilateral
NB
Fetal overgrowth, macroglossia, and ambiguous genitaliaYes/atypical Simpson-Golabi-Behmel and
Beckwith-Wiedemann S
Yes (postmortem)NoNoNoNoDead at age of 2 days

4Regalado et al., Pediatr Pathol Lab. Med., 1996 [11]NewbornMBilateral universal
NB
Prenatally diagnosed nephromegaly and renal failure NoYes (postmortem)NONoNoNoDOD at age of 3.5 mo

5Henneveld et al., Am J Med Genet., 1999 [12]8 moFUnilateral
NB
Nephromegaly FTH and other features of Perlman SYes/Perlman SYes (postmortem) NONoNoNoDead

6Spranger et al., J Clin Dysmorphol., 2001 [13]8 moMPeri- and intralobar
NB
Macrocephaly and short trunkYes/Ischiospinal dysostosis
with rib gaps
YesNONoNoNoAlive/2 mo

7Prasil et al., Med Pediatr Oncol., 2000 [7]15 moMBilateral
HPLN
Abdominal massNoYes 5 course VCR-AMD/20 wksPartial regressionNoNoYes/5 yrsAlive/5.5 yrs

8Prasil et al., Med Pediatr Oncol., 2000 [7]13 moMUnilateral
HPLN
Abdominal massNoYes3 course VCR-AMD/24 wksPartial regressionNoNoYes/28 moAlive/3.5 yrs

9Prasil et al., Med Pediatr Oncol., 2000 [7]3 yrsFBilateral
HPLN
Abdominal massNoYes2 course VCR-AMD/20 wksPartial regressionNONOYes, multifocal with anaplasia/18 moNED/4 yrs

10 Günther et al., Pediatr Radiol., 2004 [14]2 yrsFBilateral
DHPLN
NRNR NoNRNONOYes/12 moNR

11Cozzi et al., J Urol., 2004 [15]12 moFBilateral
HPLN
Abdominal massNoNo2-drug/NONOYes/4 wksNED/6 yrs

12Cozzi et al., J Urol., 2004 [15]13 moFUnilateral
HPLN
Abdominal mass/painNoNo2-drug/10 wksComplete regressionNONOYes/14 wksNED/32 mo

13Hu et al., Nephrol Dial Transplant., 2004 [16]21 moMBilateral
NB
Hypoplastic genitalia, glomerulopathy, and renal failureYes/atypical Denys-Drash S and
mutation of WT1 gene
Yes (nephrectomy at time of TN)NoNONONONR

14Hu et al., Nephrol Dial Transplant., 2004 [16]6 yrsMBilateral
NB
Pseudohermaphroditism, glomerulopathy, and renal failureYes/atypical Denys-drash S and
mutation of WT1 gene
Yes (nephrectomy at time of TN)NoNONONONR

15Christiansen et al., Pediatr Dev Pathol., 2005 [17]NewbornFBilateral
DHPLN
Congenital heart disease, anddiaphragmatic hernia Yes/mosaic duplication
1(q11q44)
Yes (postmortem)NoNONONODead at first day of life

16Machmouchi et al., Pediatr Nephrol., 2005 [18]8 moFBilateral
HPLN
Abdominal distention/respiratory distress/macroscopic hematuriaNoYesVRC-AMD-DX/24 wksPartial regressionNONONONED/1 yr

17
(sibl. of 18)
Gonzales et al., Am J Med Genet., 2005 [19]NewbornMBilateral
NB
Lumbosacral meningocele, large cystic and dysplastic kidneys, and oligohydramniosYes/diaphanospondylodysostosisYes (postmortem)NoNONONoDead at first day of life

18
(sibl. of 17)
Gonzales et al., Am J Med Genet., 2005 [19]NewbornFBilateral
NB
Oligohydramnios and cystic kidneysYes/diaphanospondylodysostosisYes (postmortem)NoNoNoNoDead at first day of life

19Traub et al., Virchows Arch., 2006 [20]Fetus 24 weeksMBilateral diffuse peri- and intralobar
NB
Yes/trisomy 13 and loss of WT1
expression
Yes (postmortem)NoNoNoNoDead at birth

20Witt et al., J Pediatr Hematol Oncol., 2009 [21]9 moFBilateral
DHPLN
Abdominal distention/respiratory distress/acquired von Willebrand diseaseYes/hip dysplasiaYes VCR-AMD/122 wks
13-cis retinoic acid/9 wks
VCR-AMD-DX/NR
Partial regressionNoNoYes/31.5 moAlive/3.6 yrs

21Vicens et al., Pediatr Dev Pathol., 2009 [22]1 yrMUnilateral
DHPLN
Abdominal massNo YesVCR-AMD/4 wksPartial regressionYesNoNoNR

22
(sibl. of 22)
Katzman et al., Pediatr Dev Pathol., 2009 [23]NewbornFCombined
NB
Prenatally diagnosed nephromegalyNoYes (postmortem)NoNoNoNoDOD at 6 day of life

23
(sibl. of 21)
Katzman et al., Pediatr Dev Pathol., 2009 [23]NewbornMIntralobar universal
NB
Prenatally diagnosed nephromegalyNoYes (postmortem)NoNoNoNoDOD at 10th day of life

24 Borny et al., JBR-BTR., 2009 [24]12 moFMultifocal
PLN
NRYes/Beckwith-Wiedemann SNRNRNRNRNRNRNR

25Sethi et al., Radiographics., 2010 [25]6 moFBilateral
DHPLN
Abdominal massNoNoNoNoNoYes/12 moAlive/NR

26Rauth et al., J Pediatr Surg., 2011 [26]10 moFBilateral
DHPLN
Urinary infectionNoNo2 courses of VCR-AMD/18 wks and 24 wksPartial regressionNoNoYes/3.5 yrsNR

Abbreviations: NB: nephroblastomatosis, Ch: chemotherapy, Srg: surgery, Ra: radiation, WT: Wilms tumor, f: female, m: male, sibl: sibling, HPRN: hyperplastic perilobar NB, DHPRN: diffuse hyperplastic perilobar NB, VRC: Vincristine, AMD: dactinomycin, DX: doxorubicin, NR: not reported, DOD: dead of disease, NED: no evidence of disease, TN: transplantation.