Early human development
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Neonatal renal tumours are rare, with only 7% of all neonatal tumours arising from the kidney. Presentation is usually as a flank mass or as a coincidental finding on either antenatal or postnatal ultrasound. Mesoblastic nephroma is the most common tumour to be found at this age, but Wilms' tumour and other malignant and benign tumours occur. ⋯ Given the low malignant potential of these tumours, treatment is by radical nephroureterctomy, except in cases with bilateral disease or syndromic patients with a high incidence of metachronous tumours. Chemotherapy is rarely indicated. Survival is generally excellent for all tumour types in this age group, the exception being malignant rhabdoid tumour of the kidney which may have metastases at presentation.
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Though some neonatal soft tissue tumours have identical biology and natural history to the same tumours in older children many tumours in this age group have a distinct and more favourable behaviour and mandate less aggressive treatment; many being curable by surgical resection alone. Accurate histological diagnosis is essential. In those instances where adjunctive chemotherapy is indicated it is essential to modify paediatric chemotherapy dosages and regimes to minimise the risk of serious adverse effects. Radiotherapy should be avoided due to its severe adverse effects on growth and the risk of inducing secondary malignancies.