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July 1981

Epidural Metastasis by Wilms' Tumor

Author Affiliations

From the Departments of Neurology (Dr Bever), Neurosurgery (Dr Antunes), and Pediatrics (Dr Wolff), Columbia-Presbyterian Medical Center, New York; the Department of Neurology, Division of Child Neurology, College of Medicine and Dentistry of New Jersey, Newark (Dr Koenigsberger); and the Laboratory of Microbial Immunity, National Institutes of Health, Bethesda, Md (Dr Bever).

Am J Dis Child. 1981;135(7):644-646. doi:10.1001/archpedi.1981.02130310048016

• Metastatic spread is common in Wilms' tumor, but spinal epidural involvement is rare. We studied two patients in whom spinal cord compression developed during treatment for Wilms' tumor. Both patients had back pain and new pulmonary metastases months after the primary diagnosis was established. One case had evidence of adjacent vertebral involvement, and successful therapy was begun while the patient had minimal neurological deficits. The second patient had back pain initially without neurological deficit or abnormality on plain spine films, followed in one month by a rapid neurological deterioration. Despite a slow and nearly complete recovery after treatment with laminectomy, radiotherapy, and chemotherapy, her condition relapsed one year later, with a compressive lesion at a higher level. Our experience stresses the importance of early recognition and treatment of this complication of Wilms' tumor.

(Am J Dis Child 1981;135:644-646)