Primary lumbosacral Wilms tumour associated with occult spinal dysraphism

A 4-year-old child presenting with sudden-onset paraplegia and a sacral tum our in association with spina bifida occulta is reported. There were no sti gmata of spinal dysraphism at birth. Imaging studies confirmed a sacral tum our with extradural extension up to T10 and spinal dysraphism. The histolog ical features of the extradural and sacral components of the tumour were co nsistent with a Wilms tumour. The differential diagnosis included a primary sacral teratoma containing Wilms tumour elements or a primary extrarenal W ilms tumour arising in association with a spinal dysraphism. There was no c linical response to chemotherapy or radiotherapy.