The Role of Ultrasonography for Diagnosing Wilms Tumor in Developing Country
Background: Overall five-year survival rate of Wilm’s Tumor (WT) in developing countries is still poor. Delayed diagnosis is one of the contributing factors, whereas early diagnosis is an important thing for the outcome. It is caused by the WT burden in developing countries that was not comparable with the number of facilities for diagnosis and treatment. Ultrasonography (USG) is the mandatory first-line imaging modality in children with a suspected abdominal mass and an overall sensitivity of76%. Additionally, it can be found in many health facilities at a lower cost, quick, non-invasive, and carries no risk of radiation. Therefore, the relationship between USG and histopathology should be measured.
Materials and Methods: A cross-sectional study with an analytical approach was performed in pediatric (0 untill 18 year of age) renal malignancy and neuroblastoma that admitted to Dr. Hasan Sadikin Hospital, Bandung between 2015-2018. Data were collected from medical records. Statistical analyses using Fisher exact test were done to determine the significance of the relationship between USG and histopathology.
Results: Forty-three samples were obtained based on inclusion criteria, such as WT (n=33), neuroblastoma (n=6), renal clear cell carcinoma (n=2), and no specific type of renal malignancy (n=2). Fisher exact test revealed the no-significant relationship between USG and histopathology with a p-value > 0.05
Conclusion: There is no significant relationship between USG and histopathology. Therefore, centralized unity for USG interpretation is recommended.
2. Vujani GM, Sandstedt B. The pathology of Wilms ’ tumour (nephroblastoma) : the International Society of Paediatric Oncology approach. J Clin Pathol. 2010;63(2):102–9.
3. Szychot E, Apps J, Pritchard-jones K. Wilms ’ tumor : biology , diagnosis and treatment. Transl Pediatr. 2014;3(1):12–24.
4. Sari NM, Reniarti L, Suryawan N, et al. Burden of Pediatric Cancer Treatment : Results of Online Pediatric Cancer Registry Prototype 1 at A Third Referral Hospital in Indonesia. Althea Med J. 2017;4(3):461–7.
5. Eggi R, Yacobda S. Wilms Tumor in Children : Results from A Large Indonesian Referral Hospital ’ s Experience Over 5 Years. J Med - Clin Res Rev. 2019;3(5):5–8.
6. Fawkner-corbett DW, Howell L, Pizer BL, et al. Wilms ’ tumor — lessons and outcomes — a 25-year single center UK Experinece . Pediatr Hematol Oncol . 2014;31(5):400-8.
7. Leslie SW, Sajjad H, Murphy PB. Wilms Tumor (Nephroblastoma). StatPearls Publ. 2019;
8. Israels T, Pidini D, Borgstein E, et al. Survival of children with a Wilms tumor in Survival of children with a Wilms tumor in Blantyre , Malawi. Pediatr Hematol Oncol. 2018;35(3):196–202.
9. Libes J, Oruko O, Abdallah F, et al. Risk Factors for Abandonment of Wilms Tumor Therapy in Kenya. Pediatr Blood Cancer . 2015;62(2):252-256.
10. Wilde JCH, Lameris W, Hasselt EHV, et al. Challenges and outcome of Wilms’ tumour management in a resource-constrained setting. Afr J Paediatr Surg . 2010;7(3):159-62.
11. Kumar NA, Bezawada S, Chaitanya SV, et al. A Retrospective Study of Wilms Tumour in Our Institute. Int J Contemp Med Res. 2016;3(8):2015–7.
12. Abdelmabood S, Kandil S , Megahed A, et al . Delays in diagnosis and treatment among children with cancer : Egyptian perspective. East Mediterr Heal J. 2017;23(6):422–9.
13. Njuguna F, Martijn HA, Kuremu RT, et al. Wilms Tumor Treatment Outcomes : Perspectives From a Low-Income Setting. J Glob Oncol. 2017;3(5):555–62.
14. Rabeh W, Akel S, Eid T, et al. Wilms tumor : Successes and challenges in management outside of cooperative clinical trials. Hematol Oncol Stem Cell Ther. 2016;9(1):20-5.
15. Olukayode AA, Richard IO, Rachael AA, et al. Pattern of computed tomography scan findings in children with Wilms’ tumor in a tertiary hospital in Lagos, Nigeria. Indian J Med Paediatr Oncol. 2014;35(1):31–5.
16. Bergeron C, Fleet R, Tounkara FK, et al. Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study. BMC Res Notes. 2017;10(1):772.
17. Bhagat S, Gauba N, Singh S, et al. Assessment and Comparison of Abdominal Masses by Sonography and Computed Tomography. J Evol Med Dent Sci. 2013;3(1):84–94.
18. Otto JH, Janse van Rensburg J, Stones DK. Post-treatment surveillance abdominopelvic computed tomography in children with Wilms tumour: Is it worth the risk? S Afr J Rad. 2015;19(1):1–6.
19. Ali Nawaz Khan, MBBS, FRCS, et al. Wilms Tumor Imaging - Ultrasonography [Internet]. Medscape. 2019 [cited 2019 Dec 16]. Available from: https://emedicine.medscape.com/article/415012-overview#a5
20. Shah SP, Epino H, Bukhman G, et al. Impact of the introduction of ultrasound services in a limited resource setting: rural Rwanda 2008. BMC Int Health Hum Rights. 2009;9:4.
21. Brillantino C, Rossi E, Minelli R, et al. Current Role of Imaging in the Management of Children with Wilms Tumor According to the New UMBRELLA Protocol Translational Medicine. Transl Med. 2019;8(2):1–16.
22. Aitken JF, Youlden DR, Moore AS, et al. Childhood cancer staging for population registries according to the Toronto Childhood Cancer Stage Guidelines. Cancer Counc Queensl Cancer Aust Brisbane. 2017. :33–7.
23. Isowo ABM, Sowunmi AC, Oyesegun AR, et al. Management of Wilm ’ s tumor at the Lagos University Teaching Hospital ( a 10‑year retrospective study ). J Clin Sci. 2019;16(2):68–73.
24. Rais F, Benhmidou N, Rais G, et al. Wilms tumor in childhood : Single centre retrospective study from the National Institute of Oncology of Rabat and literature review. Pediatr Hematol Oncol J. 2016;1(2):28–34.
25. Lowe LH, Isuani BH, Heller RM, et al. Pediatric Renal Masses: Wilms Tumor and Beyond. Radiographics. 2000;20(6):1585–603.
26. Chung EM, Graeber AR, Conran RM. Renal Tumors of Childhood: Radiologic-Pathologic Correlation Part 1. The 1st Decade: From the Radiologic Pathology Archives. Radiographics. 2016;36(2):499–522.
27. Soyemi SS, Osuoji RI, Faduyile FA, et al. Morphological Features of Wilms Tumour in a Tertiary Health Care Institution: Our Findings. J Clin Exp Pathol. 2013;3(3):1–3.
28. Okello I, Tibenderana R, Lubega A, et al. Wilms tumour among children attending Mbarara Regional Referral Hospital: Clinico-pathological characteristics and outcome at the end of treatment. East Afr J Surg. 2019;24(1):28–34.
29. Popov SD, Sebire NJ, Vujanic GM. Wilms’ Tumour – Histology and Differential Diagnosis. In: Heuvel-Eibrink MM van den, editor. Wilms Tumor. Codon Publications; 2016. p. 3–21.
30. Taskinen S, Leskinen O, Lohi J, et al. Effect of Wilms tumor histology on response to neoadjuvant chemotherapy. J Pediatr Surg. 2019;54(4):771–4.
31. Wang J, Li M, Tang D, et al. Current treatment for Wilms tumor: COG and SIOP standards. World J Pediatr Surg. 2019;2(3):e000038.
32. Yao AJJ, Moreira C, Traoré F, et al. Treatment of Wilms Tumor in Sub-Saharan Africa: Results of the Second French African Pediatric Oncology Group Study. J Glob Oncol. 2019;(5):1–8.
33. Dumba M, Jawad N, McHugh K. Neuroblastoma and nephroblastoma: a radiological review. Cancer Imaging. 2015;15(1):5.
34. de Sousa Leão LR, Mussi TC, Yamauchi FI, et al. Common pitfalls in renal mass evaluation : a practical guide. 2019;52(4):254–61
|Issue||Vol 15 No 3 (2021)|
|Wilms tumor (WT); Ultrasonography (USG); Histopathology|
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