Wilms' tumour and hypertension: incidence and outcome.
ABSTRACT To determine the incidence and outcome of hypertension associated with Wilms' tumour and to reduce peri-operative morbidity by appropriate treatment.
The medical and nursing case-notes of 17 consecutive patients with Wilms' tumour treated over a 5.5 year period (1989-1994) were analysed retrospectively.
Ten of 17 patients had hypertension, with a mean blood pressure of 150/103 mmHg (130-220 mmHg systolic and 85-145 mmHg diastolic). There was no significant difference between the hyper- and normotensive patients in their mode of presentation. Blood pressure was stabilized preoperatively in all the hypertensive patients. Perioperative monitoring in these patients was performed using arterial and central venous pressure lines. No patient had any peri-operative hyper- or hypotensive episodes caused by handling the tumour or after nephrectomy. Thirteen patients had a favourable histological diagnosis and all the hypertensive patients were in this group. The blood pressure of all patients returned to normal within 1 month of surgery.
Both the recognition of hypertension and appropriate peri-operative treatment is mandatory for the safe surgical management of this condition.
- Journal of Pediatrics 01/1950; 35(6):710-4. · 4.04 Impact Factor
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ABSTRACT: Congenital mesoblastic nephroma (CMN) is the most common renal tumor of early infancy. It is usually evident at birth as an abdominal mass and is composed of spindle-shaped cells resembling smooth muscle cells and fibroblasts. There is macroscopic and microscopic infiltration of the surrounding kidney and entrapped tubules and glomeruli are common at the edge of the tumor. In this report, we describe a case of CMN associated with hyperreninaemia and hypertension. We examined the tumor from this case and 11 other cases for the presence of renin using a polyclonal antibody to human kidney renin. Hypertension was present in three of four additional cases for which records were available. Immunoreactive renin was present in ten of the 12 cases studied. In all of these cases, intense staining was present in vessels within the areas of the trapped cortex. In seven cases, renin was identified in the walls of vessels within the tumor itself without identifiable adjacent cortical structures. These findings indicate that CMN may often be associated with primary reninism in early infancy.Human Pathlogy 12/1988; 19(11):1347-51. · 2.84 Impact Factor
Article: Renin producing Wilms' tumor.[show abstract] [hide abstract]
ABSTRACT: A 4-yr-old boy with Wilms' tumor, hypertension, and hyperreninemia is presented. Three times as much renin was extracted from tumor tissue as from adjacent renal parenchyma, suggesting that the tumor itself was the primary source of the renin and cause of the hypertension. Other reported cases of hypertension and increased renin production with Wilms' tumor are reviewed. Hypertension is a very frequent finding in patients presenting with Wilms' tumor. The possibility that many of these neoplasms may be found to hypersecrete renin if properly investigated is discussed.Journal of Pediatric Surgery 03/1981; 16(1):32-4. · 1.38 Impact Factor