Gupta Ayushi,  Monforte Hector,  Schaaf William,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-031

Pediatric patients can host a variety of benign and malignant renal tumors and tumor mimics. Their clinical presentation is nonspecific as patients may be asymptomatic or present with an abdominal mass, flank pain, or hematuria. Proper patient management requires an accurate diagnosis based on a combination of radiological and pathological findings. Read More

Authors:  Gupta Ayushi , Monforte Hector , Schaaf William , Kucera Jennifer

Keywords:  renal tumor, Wilms tumor, renal cell carcinoma

Shannon Leann,  Singh Sudha

Final Pr. ID: Poster #: EDU-085

With research pushing ever onward, it is often difficult to keep pace with the dynamic landscape of pediatric abdominal tumors and their classification systems. However, it is imperative that we, as radiologists, remain vigilant of these changes, as our initial and follow-up imaging assessments often have the potential to drive clinical intervention in widely differing directions.

In this educational poster, we will review the most up-to-date risk stratification and staging criteria for neuroblastoma, hepatoblastoma, and Wilms tumor in order to:

1. Educate about the most recent criteria for categorizing pediatric abdominal tumors such as neuroblastoma, hepatoblastoma, and Wilms tumor.

2. Provide imaging examples of these pediatric abdominal tumors and describe how the above-mentioned criteria might change radiology reports and patient management.

3. Encourage accurate risk stratification of these tumors so that radiologists are better equipped to assist in directing appropriate patient care. Read More

Authors:  Shannon Leann , Singh Sudha

Keywords:  neuroblastoma, hepatoblastoma, Wilms

Grundlehner Paul,  Gibson Donald

Final Pr. ID: Poster #: CR-014

Wilms tumor is a common malignant renal neoplasm in children and accounts for the vast majority of renal tumors in children. Modern treatment regimens have increased overall survival for Wilms tumor to over 90%[1]. Despite this, 10-15% of patients with favorable histology and up to 50% with anaplastic histology will experience primary progression or recurrence. The most common site of recurrence is to the lungs and the liver[2]. Peritoneal disease and recurrence has been described[3-4].
We present an interesting case of a 13-year-old female with extensive peritoneal recurrence of Wilms tumor. The patient initially presented at the age of 12 with a 3-day history of abdominal pain. CT revealed a 13 cm right renal mass with no other lesions in the chest, abdomen, or pelvis. She underwent right nephrectomy, during which she was upstaged to stage 3 when tumor rupture occured. Histology was favorable. She completed chemo and radiotherapy. CT CAP at 6 months follow-up showed no recurrent disease. Approximately 7 months later or 13 months after initial diagnosis the patient presented with constipation and abdominal pain. Initial non-contrast CT demonstrated filling of the abdomen and pelvis with a high density material(Figure 1). Given the patient’s history and concern about some nodularity to the density, MRI was performed and demonstrated extensive heterogeneous mass-like peritoneal disease filling the abdomen and pelvis(Figure 2). There were additional areas of peritoneal caking and thickening(Figure 3). Ultrasound guided biopsy was performed and the pathology was identical to that of the excised Wilms.
While unusual recurrent Wilms tumor should be included in the differetial diagnosis of massive intraperitoneal neoplasia

1. Metzger, M. L. (2005). Current Therapy for Wilms Tumor. The Oncologist, 10(10), 815-826. doi:10.1634/theoncologist.10-10-815
2. Dome, J. S., Rodriguez-Galindo, C., Spunt, S. L., & Santana, V. M. (2014). Pediatric Solid Tumors. In Abeloff's Clinical Oncology (5th ed.). Philadelphia: Churchill Livingstone/Elsevier.
3. Brisse, H. J., Schleiermacher, G., Sarnacki, S., Helfre, S., Philippe-Chomette, P., Boccon-Gibod, L., . . . Neuenschwander, S. (2008). Preoperative Wilms tumor rupture. Cancer, 113(1), 202-213. doi:10.1002/cncr.23535
4.Slasky, B. S., Bar-Ziv, J., Freeman, A. I., & Peylan-Ramu, N. (1997). CT appearances of involvement of the peritoneum, mesentery and omentum in Wilms tumor. Pediatric Radiology, 27(1), 14-17. doi:10.1007/s002470050053 Read More

Authors:  Grundlehner Paul , Gibson Donald

Keywords:  Wilms, Recurrence, Intraperitoneal

Evans Catherine,  Ardestani Allen,  Watterson Christopher,  Patel Snehalkumar

Final Pr. ID: Poster #: EDU-106

The objectives of this educational exhibit are (1) To review the radiologic appearance of pediatric renal tumors in multiple imaging modalities, (2) To review the demographic and clinical contexts in which pediatric renal tumors occur, and (3) To survey various syndromes classically associated with pediatric renal tumors. Read More

Authors:  Evans Catherine , Ardestani Allen , Watterson Christopher , Patel Snehalkumar

Keywords:  Wilms tumor, renal cell carcinoma, WAGR, tuberous sclerosis, mesoblastic nephroma

El-ali Alexander,  Sameer Mittal,  Calle Toro Juan,  Shah Jay,  Lawton Brendan,  Kolon Thomas,  Long Christopher,  Back Susan

Final Pr. ID: Paper #: 094

There is no standardized system for assessment of which pediatric tumors are amenable to partial nephrectomy – a surgery that is considered in pediatric patients with bilateral renal masses and those with predisposition syndromes. The RENAL Nephrometry score is the most widely used system to assess renal tumor complexity for surgical decision making in adults. We evaluated the RENAL Nephrometry score and imaging features that might predict perioperative clinical outcomes. Read More

Authors:  El-ali Alexander , Sameer Mittal , Calle Toro Juan , Shah Jay , Lawton Brendan , Kolon Thomas , Long Christopher , Back Susan

Keywords:  Partial Nephrectomy, Wilms Tumor, Patient Outcomes

Aslan Mine,  Arioz Habibi Hatice,  Kalyoncu Ucar Ayse,  Ozmen Evrim,  Aslan Ahmet,  Bakan Selim,  Yildirim Onur,  Kurugoglu Sebuh,  Adaletli Ibrahim

Final Pr. ID: Poster #: SCI-021

The diagnosis of Wilms tumor and adrenal gland neuroblastoma can be challenging, even with imaging methods such as computed tomography and magnetic resonance imaging (MRI). This study aimed to show the utility of diffusion weighted MRI (DW-MRI) in the differentiation of neuroblastoma and Wilms tumor. Read More

Authors:  Aslan Mine , Arioz Habibi Hatice , Kalyoncu Ucar Ayse , Ozmen Evrim , Aslan Ahmet , Bakan Selim , Yildirim Onur , Kurugoglu Sebuh , Adaletli Ibrahim

Keywords:  Wilms tumour, Neuroblastoma, Diffusion weighted imaging, Apparent diffusion coefficient

Sala Simone,  Cirillo Marco,  Raimondi Edoardo,  Bassi Matteo

Final Pr. ID: Poster #: CR-016

The incidence of upper genitourinary anomalies in children has been reported up to 4-6% and the association of cryptorchidism, hypospadias, double collecting system or fused kidney with Wilms’ tumor is well known. Horseshoe kidney is a rare anomaly of fusion occurring between 4^th and 6^th weeks of gestation. The association of Wilms’ tumor with horseshoe kidney is uncommon, with limited cases described. The incidence varies from 0.4% to 0.9% of all Wilms’ tumor. Rare variants of Wilms’ tumor like extrarenal teratoid tumor have also been described in children with horseshoe kidney. We describe two cases of Wilms’ tumor arising from horseshoe kidney, detected on US and later confirmed on CE-CT with low-dose imaging protocol. Both cases underwent surgical resection of the abnormal kidney and the diagnosis of Wilms’tumor was confirmed on microscopic examination of the excised tumor. In presence of kidney abonormalities imaging surveillance and follow-up evaluation is mandatory in order to grant an early detection of neoplastic evolution.
In our experience, multislice CT allows complete preoperative evaluation of this rare condition mainly using multiplanar reconstructions and may facilitate surgery. Read More

Authors:  Sala Simone , Cirillo Marco , Raimondi Edoardo , Bassi Matteo

Keywords:  wilms, horseshoe kidney