Brain metastasis of Wilms tumor with diffuse anaplasia and complex cytogenetic phenotype in a child with neurofibromatosis Type 1

Case report

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The authors report the first case of a Wilms tumor (WT) with diffuse anaplasia metastatic to the brain in a 13-year-old girl with a history of neurofibromatosis Type 1. At presentation, the metastatic tumor had radiological features that suggested a meningioma. Histologically it was characterized by striking anaplasia and features similar to the patient's previously resected WT with diffuse anaplasia.

Abbreviations used in this paper: AE1/AE3 = low- and high-molecular-weight cytokeratin; NF1 = neurofibromatosis Type 1; WT = Wilms tumor.

Article Information

Address correspondence to: Marianna Shvartsbeyn, M.D., Department of Pathology, New York University, 522 First Avenue, Smilow, 301C, New York, New York 10016. email: Marianna.Shvartsbeyn@nyumc.org.

© AANS, except where prohibited by US copyright law.

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Figures

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    Axial T2-weighted FLAIR MR imaging study revealing a homogeneously enhancing dural-based mass along the lateral aspect of the left middle cranial fossa; meningioma was suspected.

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    Photomicrographs of histological sections demonstrating an undifferentiated blastemal component in the primary renal tumor (A) and in the brain metastasis (B). Photomicrographs of the original WT showing focally myxoid stroma with abundant neoplastic cells (C), some forming primitive tubules (D), highlighted by AE1/AE3 (inset). H & E. Original magnification × 20 (A–C, inset) and × 40 (D).

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    Photomicrographs of tumor sections showing cytological features, which included severe anaplasia with numerous hyperchromatic, bizarre cells and scattered multipolar mitotic figures in the renal tumor (A and B) and in the metastatic neoplasm (C and D). H & E. Original magnification × 40 (A–C) and × 60 (D).

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