The eponym Wilms tumor is well known to pediatric oncologists all over the
world and refers to the most common form of renal cancer in the pediatric age
group. Its occurrence in adults is rare, but not unheard of. Wilms tumor, also
referred to as nephroblastoma, is named after the German surgeon Max Wilms, who
was born Nov. 5, 1867 in Hünshoven near Aachen, Germany.
After obtaining his medical degree from the Rheinische Friedrich-Wilhelm
Universitåt Bonn in Germany in 1891, the young Wilms was attracted to
surgery. In a move that would raise many eyebrows in todays culture of
focusing narrowly and if possible, early on, Wilms deliberately sought to
expand his experience before going into surgery. He successfully applied to
work as a pathologist for four years under Eugen Bostroem at the
Pathologisch-Anatomischen Institut in Giessen. As fate would have it, it was
during these years that he saw his first nephroblastoma that would result in
his famous 1899 monograph Die Mischgeschwülste der Niere.
As has been reported before, Wilms was not the first one to describe what
later became known as Wilms tumor. Review of the literature suggests that
Thomas F. Rance in 1814 may have been the first to describe this pediatric
tumor, although Rances histologic description is not very specific and
could indeed have represented another pediatric tumor of the kidney. Doubt
about the diagnosis of Wilms tumor does not exist for Carl Joseph Eberths
1872 manuscript on a young patient with bilateral renal tumors.
Although Wilms was definitely not the first one to describe the tumor, he
provided such a comprehensive review of pediatric renal tumors (adding a few
new cases from his own experience) that the disease entity that bears his name
became recognized as a separate entity. This eponym exists despite the fact
that five years prior to Wilms manuscript the German pathologist Felix V.
Birch-Hirschfeld and his countryman and gynecologist/obstetrician Albert
Siegmund Gustav Döderlein reported that they believed that a distinct
pediatric renal cancer type had previously been described. They believed the
cancer type had been described using a number of different terms, such as
mesoblastic sarcoma, embryonal sarcoma, adenosarcoma and nephrogenous
For a very brief period, what we now refer to as Wilms tumor was known as
Birch-Hirschfeld tumor in the German literature. For unknown reasons, Wilms
manuscript was noted more broadly in the literature than that of
Birch-Hirschfeld and Döderlein and eventually resulted in the eponym that
carries his name. Wilms recognized that all tissues seen in nephroblastoma
develop from cells of the mesoderm similar to the growth of an embryo,
all these tissues develop from a common and macroscopically undifferentiated
After four years in Giessen, Wilms briefly joined the department of internal
medicine in Köln as a pathologist before starting his formal surgical
training in 1897 with the world renowned Friedrich Adolf Trendelenburg in
Leipzig. During his early years as a surgeon, Wilms wrote a textbook entitled
Der Ileus: Pathologie und Klinik des Darmverschlusses, a book on
the surgical aspects of intestinal obstruction. Oddly, until then, intestinal
obstruction had been viewed as a medical, not surgical, problem. His
contribution became a landmark in medical literature and established him as a
His first position of chief of a surgical service was in Basel, Switzerland.
Shortly afterward, in 1910, he was given the opportunity to succeed professor
Albert Naraths as chairman of the very prestigious department of surgery in
Heidelberg. He accepted and would remain in Heidelberg until his untimely death
caused by diphtheria in 1918.
Aside from the manuscript that gave nephroblastoma its currently favored
name, Wilms contributed to medicine with several innovations. Among his
contributions was the design of a tendon suture technique, known in German
literature as the Wilms-Sieverischen suture. He also developed a
spinal cord pressure mercury manometer that was extensively used during World
War I and an X-ray exam table that prevented superposition of the spine over
the esophagus. In so doing, his table provided a better way to visualize and
examine the esophagus.
In pediatric oncology, Wilms name is used daily. More than 500 children are
diagnosed each year with Wilms tumor in North America alone. Fortunately, the
diagnosis does not carry a grim prognosis anymore. To the contrary, Wilms tumor
is considered one of the most curable pediatric cancers, so the use of Max
Wilms last name is associated with hope and success.
Coppes-Zantinga AR, Coppes MJ. Max Wilms and Die
Mischgeschwülste der Niere. CMAJ. 1999;160:1196.