Nephroblastomas in Postpubertal Patients
JH Barton, IA Sesterhenn, B Furusato. Armed Forces Institute of Pathology, Washington, DC; Center for Prostate Disease Research, Rockville, MD
Background: Nephroblastomas in postpubertal patients (defined as 13 years of age or older) are rare and usually the subject of individual case reports or small groups of patients. The purpose of this study is to report on the experience of the Armed Forces Institute of Pathology.
Design: The Kidney Tumor Registry of the AFIP contains 97 patients diagnosed as nephroblastoma in postpubertal patients beginning in 1967. The clinical charts and slides were reviewed and the tumors were classified using the same categories as the pediatric age group, and the same definition for unfavorable histology.
Results: Triphasic tumors were identified in 15 patients (8 males and 7 females) from the 2nd to 8th decades, and 10 died of disease. Blastemal tumors were found in 37 patients (23 males and 14 females), mostly in the 3rd decade. Ten died of disease and 4 were living with disease. Biphasic epithelial /blastemal tumors were seen in 33 patients (10 male and 17 females, with sex in the reminder unknown), mostly in the 2nd and 3rd decades. Only one death was observed in this group, occurring in a patient with unfavorable histology. Nine were living and well. Pure epithelial tumors, 5 with focal maturation, were found in 12 patients (5 males and 7 females), mostly in the 2nd and 3rd decades, and only one died of disease. Seventy-five percent of triphasic tumors were stage II or greater, 55% of blastemal tumors were stage II or greater, and 64% of biphasic tumors were stage II or greater. In contrast, eight of twelve pure epithelial tumors (including all with maturation) were stage I.
Conclusions: In postpubertal patients, triphasic and blastemal nephroblastomas behaved aggressively, whereas biphasic did so only if unfavorable histology was present. Epithelial nephroblastomas had a good prognosis, particularly if there was evidence of maturation.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 9:00 AM
Platform Session: Section A, Tuesday Morning