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Wilms' tumour

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Wilms' tumour is a highly malignant, usually unilateral and rapidly developing tumour of the kidney, composed of malignant epithelial and mesodermal cells. Initially, asymptomatic; later, moderate local pain, nausea, vomiting, apathy, and fever. There is also pallor, weight loss, abdominal distension, and blood hypertension It is the most common malignous kidney tumour in children, usually affecting children aged 3-4 years. 75 percent of patients are under 5 years, but it has also been reported in adults. In the past, the mortality from this cancer was extremely high. Newer approaches to therapy have been very effective in controlling the tumor. In a small proportion of patients Wilms' tumor occurs in conjunction with absence of the iris and the familial form of the association is inherited as an autosomal dominant trait.

According to one author, the earliest record of Wilms' tumour dates from 1814, with similar cases reported over the next few decades, but convincing histological evidence was not presented until 1872. William Osler in 1879 published a paper detailing four cases found in the literature plus two of his own. Birch-Hirschfeld in 1898 recognised the unitary nature of the disease. Max Wilms in 1899 described seven cases and acknowledged his debt to Birch-Hirschfeld and other predecessors.


  • F. V. Birch-Hirschfeld:
    Sarkomatöse Drüsengeschwülste der Niere im Kindesalter (Embryonales Adenosarcom).
    Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie, 1898, 24: 343-362.
  • M. Wilms:
    Die Mischgescwülste. I. Die Mischgescwülste der Niere.
    Leipzig, A Georgi, 1899.

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