Foreword

I have been lucky and privileged to work with the Société Internationale d’Oncologie Pédiatrique (SIOP) panel of pathologists for 40 years. During this time, I have seen steady and remarkable progress and success in the treatment of Wilms’ tumour, with an increase in survival rates from around 50 to more than 90%. Max Wilms, a German pathologist and surgeon, hardly realized that his thesis on “Mischgeschwulste der Niere” (“Mixed tumours of the kidney”; 1899) would link his name to the most common renal tumour in children and also turn out to be an example of successful multimodal treatment. He collected nine, mostly large, tumours from children aged 11 weeks to 11 years, which were described as round cells or myosarcomas with a content of epithelial structures in which he saw the confusing similarity to the embryonic kidney. He suspected that the component he termed “round cell sarcoma” represented tumour stem cells with the potential for differentiating into mesenchyme and epithelium and proposed its origin from the “kidney blastema” and extensively discussed oncogenesis compared with renal embryology. In the first half of the 20th century, surgical excision was the only treatment often with a fatal outcome partly due to large tumour size. Read more…..