IPLab:Lab 13:Wilms Tumor

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Clinical Summary[edit]

The mother of this three-year-old male noticed a large mass in his abdomen. There were no other complaints. Physical examination and x-rays--including an intravenous pyelogram (IVP)--showed a large right renal mass. At surgery, a 550-gram right kidney was removed. There was no lymph node involvement, no extrarenal mass, and no involvement of the other kidney. Lung and bone x-rays showed no metastases. However, microscopic study of the surgical specimen showed infiltration by the tumor (Grade II neoplasm) which had been difficult to separate from the duodenum. The child was placed on chemotherapy. Four months after the surgery to remove the tumor, a nodule was found in the lungs. The chemotherapy was resumed but the patient died four weeks later due to complications of Gram-negative sepsis.

Autopsy Findings[edit]

At autopsy there was a single tumor nodule in the lungs.


Virtual Microscopy[edit]

Study Questions[edit]

Additional Resources[edit]


Journal Articles[edit]


The patient is given an intravenous injection of contrast medium that rapidly enters the urine. Radiographs are then taken to show the passage of the contrast-containing urine through the pelvicaliceal system.

A normal kidney for a child this age should weigh 50 grams.

Gram-negative sepsis is a systemic inflammatory response caused by the presence of Gram-negative bacteria and their endotoxins in the blood. The microbes usually enter the bloodstream from an area of localized infection. Gram-negative sepsis is the leading cause of septic shock--hence, also known as "endotoxic shock." Septic shock is a syndrome of inflammatory responses which can lead to severe hypotension, multiple organ system failure, and death.

Renal failure is the severe reduction of renal function and often leads to reduced urinary output.

The normal fibrinogen level is 184 to 412 mg/dL.