Hussain S, Nizami S, Tareen F.
Neonatal extra-renal Wilm`s Tumour.
J Pak Med Assoc Jan ;54(1):37-8.

An eight days old male neonate presented with 3 days history of Jaundice, Abdominal distension and one episode of haematemesis. Clinical examination revealed a 3.0 kg lethargic and icteric neonate. His abdomen was distended with visible veins. A well defined abdominal mass was palpable in right Iliac fossa. Haematological and biochemical examination were normal except, total bilirubin 13 mg/dl alfa-fetoprotein 6138 IU/ml; LDH 1463. Ultrasound scan and CT abdomen (Figure 1) revealed a 8x9cm heterogeneous mass in lower abdomen which was extending across the midline and also entering into spinal canal. Right kidney was hydronephrotic but both kidneys were free of any tumour and were well away from the mass. On exploratory laparotomy a lobulated mass was present in lower abdomen retroperitoneally. It was extending from bifurcation of aorta up to coccyx and extending in both the flanks. On the right side mass was over ileo-psoas and on the left side it was extending behind the ileopsoas and was tethered to the vertebral column. The right iliac vessel and ureter was stretched over the tumour. Mass was excised completely but spinal canal was not opened. Histology showed mass to be well encapsulated, yellow and soft in consistency. Microscopically features were those of Willm`s tumour.

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