Rhabdoid Wilms' tumour and prostaglandin-mediated hypercalcaemia

A nine-month-old girl with a rare rhabdoid variant of Wilms' tumour but no sign of bony metastases developed hypercalcaemia both at the time of diagnosis and at relapse. Tissue culture studies showed that primary tumour tissue and cells cultured from it released significant bone resorting activity, attributable to prostaglandins, into the culture medium, whereas tissue from a normal kidney and a Wilms' tumour not associated with hypercalcaemia did not. Serum parathyroid hormone (PTH) levels were normal and PTH was not found in the culture medium of tumour tissue. These results are consistent with the hypothesis that tumour-derived prostaglandins were responsible for the hypercalcaemia in this patient.