Search

Four infants had adrenal masses detected prenatally, through ultrasonography, between 18 and 30 weeks' gestation. Two were predominantly cystic, and two were solid. The sizes ranged from 0.8 to 1.5 cm. There were no associated prenatal maternal complications or stress factors. The urine vanillylmandelic acid levels at birth were normal in three infants. Two infants had a documented decrease in mass size at birth (compared with the last intrauterine study). All masses had a progressive decrease in size after birth, and ultrasound results were normal at 6 to 12 weeks of age. All four patients are well, with normal study results, at 2 to 5 years of age.

Several metastatic nodules were discovered in the lungs of a 4-year-old boy two years after surgical excision of Wilms' tumor with subsequent chemotheraphy and local irradiation. All these metastatic nodules were composed of differentiated mesenchymal elements similar to those encountered in the primary neoplasm. Similar “mature” metastases have been observed by pathologists in other tumors of embryonic origin. Review of available literature and clinical and experimental data supports the notion that “reversion” of malignant cells into phenotypically benign counterparts may take place spontaneously or under the influence of environmental factors. Anticancer agents (cytostatics, radiation) selectively destroy the more anaplastic cells present in a malignant tumor (or its metastatic implants), thus allowing the “benign” revertants to predominate. Although such lesions are benign-appearing, it is recommended that they be completely excised; however, but further chemo- or radiotherapy may not be necessary.

Several metastatic nodules were discovered in the lungs of a 4-year-old boy two years after surgical excision of Wilms' tumor with subsequent chemotheraphy and local irradiation. All these metastatic nodules were composed of differentiated mesenchymal elements similar to those encountered in the primary neoplasm. Similar “mature” metastases have been observed by pathologists in other tumors of embryonic origin. Review of available literature and clinical and experimental data supports the notion that “reversion” of malignant cells into phenotypically benign counterparts may take place spontaneously or under the influence of environmental factors. Anticancer agents (cytostatics, radiation) selectively destroy the more anaplastic cells present in a malignant tumor (or its metastatic implants), thus allowing the “benign” revertants to predominate. Although such lesions are benign-appearing, it is recommended that they be completely excised; however, but further chemo- or radiotherapy may not be necessary.