4 yrs old girl underwent left nephrectomy due to 1 month pretreated Wilms tumor (nephroblastoma).  
MACRO: 1 largest multicystic myxoid gelatinous nodule in lower pole 4,5x4,5 cm with flesh dark red nidus. 1.5cm yelow nodules: 1 closed to main, another in upper pole (photos).  
HISTO:  
MAIN TUMOR: 3-component nephroblastoma with therapic effect (necrosis and xanthogranulomatous inflammation). Outside capsule of the tumor- confluent proliferating or dormant/fibrotic blastema rest. In the center of blastemal/epithelial component- focal accumulation of large lipidised "adrenal adenoma like" cells.  
SATELITES (2): Identical blastema rests with necrosis.  
IH (adrenal rest tumor only): Vimentin(+/++) 70%, PANCK(+/++) 70%, MelanA(+++)100%, CD10(-), EMA(-), RCC(-), CD117(-), HMB45(-), p504s(-), CD68(-), Calretinin(+) 5%, ChromograninA(-), WT1(-), CD57(-), NSE(+/+++) 30%, Inhibin A(++/+++) 100%, Synaptophysin (+/+++) 100%, p53(+) 30%, Ki67<2% (++).  
 
PROPOSAL: Nephroblastoma with posttherapy changes and perifocal and 2 separate nidus of blastema (nephroblastomatosis?). Adrenal rest tumor within nephroblastoma.  
Thankyouforalldone.