A 61-year-old woman underwent a left radical nephrectomy for Stage I1 anaplastic Wilms' tumor. She received no adjuvant therapy. One year later computerized tomography (CT) of the abdomen revealed a mass in the left renal fossa and retroperitoneal adenopathy. A CT-guided needle biopsy was nondiagnostic. The patient had progressive disease after treatment with dactinomycin, doxorubicin, and vincristine, but achieved a complete response after treatment with cisplatin and etoposide. The therapy of Wilms' tumor in adults is discussed. Cancer 67:956-959,1991.
ILMS' TUMOR is the fourth most common solid W tumor of childhood, accounting for 5% of all childhood cancers, with 350 new cases diagnosed yearly in the United States.' Wilms' tumor also rarely occurs in the adult, with approximately 200 cases reported in the literature to date.' Adult patients tend to present with more advanced disease and have a poorer prognosis than children with the same stage.3 Responses have been described after treatment with chemotherapy in adults.' Little information is available regarding alternative treatments for children o r adults who fail initial chemother-
We recently encountered an adult patient with recurrent anaplastic (unfavorable histologic type) Wilms' tumor who progressed after therapy with vincristine, doxorubicin, and dactinomycin, but who had a durable complete remission after treatment with cisplatin and etoposide.
Case Report
A 6 1-year-old white woman presented with abdominal pain and hematuria. Computerized tomography (CT scan) of the ab-