Part 2b: Developmental Tumours

Tumours as Developmental Disorders

“From very many accounts and things learned little by little,
when one gathers them together and studies them thoroughly,
whether the things are like one another;
again whether the dissimilarities in them are like each other…
this would be the method.”
– Hippocrates (Epidemics) –
Tumours as Developmental Disorders

The second branch of the developmental disorders involves tumours that have their origins in embryonic development – they start to grow even before birth. Like other tumours (discussed later in the chapter) developmental tumours may be benign or malignant.

The great German surgeon Max Wilms was one of the first researchers to understand the principle of developmental tumours. One particularly aggressive tumour now bears his name, the Wilm’s tumour, a renal tumour seen in young children.

Another developmental lesion to keep in mind are peculiar tumour-like malformations which we know as ‘hamartomas’. A common example you will have seen is the haemangioma or ‘port wine stain’.
A harmatoma is a tumour-like malformation, composed of tissue native to the organ of origin, and growing ‘pari-passu’ (in and around) that tissue.
Max Wilms (1867-1914). Professor of surgery in Germany, Wilms was a highly intelligent man with a huge work capacity. He made great efforts to map the pathology and development of tumour cells and after painstaking work concluded that some tumours are initiated already in the development of the embryo.

During World War I, Wilms performed an emergency cricothyroidotomy on a French prisoner of war who had laryngeal swelling due to diphtheria. Wilms acquired the disease in a severe septic form and died a few days later, aged 51 and at the peak of his career. The French officer survived.