KIDNEY - Carcinoma

This shows a portion of a kidney greatly extended and replaced by tumour, in which there are areas of necrosis. The tumour extends into the renal vein which is distended to some 2.5 to 3 cms. in diameter. The tumour has burst through the renal parenchyma at the apex of the specimen, but elsewhere appears contained within a thin rim of kidney tissue.
This girl, at the age of 16, was admitted to hospital in February 1976 with a story that, four months before admission, she had had an episode of fever, haematuria and right abdominal pain. Latterly she had noted weight loss and abdominal swelling. Examination showed a huge right-sided abdominal mass, and there was evidence of pulmonary embolism. Because of her age, this was regarded as a Wilm's tumour and she had pre-operative radiotherapy and chemotherapy. Postoperatively she had further therapy but she died in April 1977, approximately 1 year after the tumour had been removed. Histologically the tumour was a clear-celled adenocarcinoma, remarkable for its size.