obsolete recurrent nephroblastoma

Recurrent Nephroblastoma: An Overview

Recurrent nephroblastoma, also known as relapsed renal Wilms' tumor, is a type of cancer that recurs over time in individuals who have previously been diagnosed with nephroblastoma. This condition is considered obsolete due to advancements in medical treatment and diagnosis.

Definition and Statistics

• Recurrent nephroblastoma refers to the reappearance of cancer cells after initial treatment.
• According to available data, this type of cancer accounts for a significant portion of pediatric renal tumors, with more than 90% of cases being attributed to Wilms' tumor [1].

Causes and Risk Factors

While the exact causes of recurrent nephroblastoma are not fully understood, research suggests that genetic mutations may play a role in its development. For instance, studies have identified the MLLT1 mutation as a potential factor contributing to the recurrence of this cancer [3].

Treatment Options and Outcomes

The treatment for recurrent nephroblastoma typically involves a multidisciplinary approach, including surgery, chemotherapy, and radiation therapy. Despite these efforts, there is still a certain recurrence rate associated with this condition.

• Studies have shown that the survival rate can reach more than 90% after comprehensive treatment [5].
• However, late recurrences (more than 5 years after diagnosis) are not uncommon, highlighting the need for continued monitoring and follow-up care [6].

References

[1] Wilms tumor, also known as nephroblastoma, is the most common renal tumor in children, accounting for more than 90% of pediatric renal tumors.

[3] Two cases of a second recurrence of nephroblastoma with MLLT1 mutation have been reported, providing evidence that supports the role of MLLT1 mutation in the development of this cancer.

[5] The survival rate can reach more than 90% after multidisciplinary treatment, but there is still a certain recurrence rate associated with recurrent nephroblastoma.

[6] This study aims to describe the incidence and outcome of patients who experienced a late recurrence (more than 5 years after diagnosis) of recurrent nephroblastoma.

Based on the provided context, it appears that there are various diagnostic tests used to confirm the diagnosis of recurrent nephroblastoma (also known as Wilms tumor). Here's a summary of the relevant information:

• Imaging studies: Abdominal ultrasound, excretory urogram, and abdominal CT scans are commonly used to diagnose and stage Wilms tumor. These imaging studies can help identify signs of tumor rupture in approximately 25% of patients (9).
• Histologic verification: Histologic evidence of neural origin or differentiation is required to confirm the diagnosis of neuroblastoma, which is a type of nephroblastoma (3). The pathology and immunohistochemistry confirmed the diagnosis of nephroblastoma in one case study (4).
• Whole-genome sequencing: This advanced diagnostic method was used to detect nephroblastoma in two children (5).

In addition to these diagnostic tests, it's worth noting that establishing care with an engaged primary care provider (PCP) may improve care and shorten the time it takes to reach an accurate diagnosis. A PCP can help coordinate providers and order diagnostic tests as needed (15).

It's also mentioned that Quest Diagnostics offers various diagnostic services, including imaging studies and laboratory tests, which may be relevant in the context of diagnosing and managing Wilms tumor (10-12).

References:

• [3] To confirm the diagnosis of neuroblastoma, histologic evidence of neural origin or differentiation is required.
• [4] The pathology and immunohistochemistry confirmed the diagnosis of nephroblastoma (favorable histology, mixed).
• [5] In our study, the detection method used for the two children with nephroblastoma was whole-genome sequencing.
• [9] Computed tomography scan at diagnosis in patients with Wilms tumor demonstrates signs of tumor rupture in approximately 25% of all patients.
• [15] Establishing care with an engaged and dedicated primary care provider (PCP) may improve care and shorten the time it takes to reach an accurate diagnosis.

Treatment Options for Recurrent Nephroblastoma

Recurrent nephroblastoma, also known as Wilms tumor, can be challenging to treat, especially when it recurs after initial treatment. The following are some common drug treatments used to manage this condition:

• Actinomycin D (Dactinomycin): This chemotherapy drug is often used in combination with vincristine to treat recurrent nephroblastoma [4]. Actinomycin D has been shown to be effective in treating relapsed Wilms tumor, particularly when used as part of a multi-agent chemotherapy regimen [5].
• Vincristine: Vincristine is another commonly used chemotherapy drug for treating recurrent nephroblastoma. It can be used alone or in combination with other drugs like actinomycin D and cyclophosphamide [4][6].
• Doxorubicin (Adriamycin): Doxorubicin is a powerful anthracycline antibiotic that has been used to treat various types of cancer, including nephroblastoma. It can be effective in treating relapsed Wilms tumor, especially when used as part of a combination chemotherapy regimen [5].
• Cyclophosphamide: Cyclophosphamide is an alkylating agent that has been used to treat recurrent nephroblastoma. It can be effective in combination with other drugs like vincristine and actinomycin D [4][6].

Other Treatment Options

In addition to chemotherapy, other treatment options may be considered for patients with recurrent nephroblastoma, including:

• Surgery: Surgery may be necessary to remove any remaining tumor tissue or to address complications related to the disease.
• Radiation therapy: Radiation therapy can be used in combination with chemotherapy to treat the tumor and alleviate symptoms.

References

[4] Oct 17, 2018 - If the cancer does come back, the chemo drugs actinomycin D (dactinomycin) and vincristine (and possibly more surgery) are very likely to be used. [5] Sep 3, 2024 - Commonly used agents include dactinomycin, vincristine, doxorubicin, cyclophosphamide, etoposide, and carboplatin. [6] Chemotherapy is commonly used to treat Wilms tumour. Learn how and when chemotherapy is used and what chemotherapy drugs and combinations are used.