Staging/Forms 3 (Nephroblastoma)

Figure tuab_3a_n.jpg to tuab_3c_n.jpg: Resected tumor of the retroperitoneum in a 4.4-year-old girl. Figure tuab_3a_n.jpg: Tumor of the right side with a length of 9 cm. On the left side of the hilus which is recognizable by a rest of ligature, normal kidney tissue is visible up to the lower pole. The spreading of the organ by the tumor masses of the upper pole and tumor processes are visible growing in a lateral direction. Figure tuab_3b_n.jpg: After incision, the tumor involves 80 to 90 % of the kindney, which is in contrast to the first impression; the incision plane is colored and polymorphous. Figure tuab_3c_n.jpg: The lumen of the right renal vein is dilated and filled up with white masses. Figure tuab_3a_n.jpg to tuab_3c_n.jpg: It is a Wilms' tumor which at surgery is of intermediate size and which must be classified as stage 2 ( II ) due to the presence of tumor in the right renal vein. This case illustrates the significance of the operative findings for the final staging. Although normal kidney tissue is recognizable in figure tuab_3a_n.jpg, tuab_3b_n.jpg and tuab_3c_n.jpg there is a large tumor process within the lumen of the renal vein up to the entrance into the inferior vena cava. Figure tuab_3b_n.jpg: Beside vital tumor and kidney tissue, extensive tumor necrosis and some hemorrhage in the tumor are recognizable.