Hektoen International

A Journal of Medical Humanities

The eponymous tumors of the kidney: Wilms and Grawitz

In a time when diseases were often named after the first person to describe them, kidney tumors were classified into Wilms tumors for children and Grawitz tumors for adults. Both names supposedly honored the memory of these pioneers, and unlucky candidates sitting for medical examinations were sometimes expected to know who these people were.

Portrait of Max Wilms. Wellcome Collection. CC BY 4.0.

Max Wilms (1867–1918) was the son of a German lawyer, born in the town of Hünshoven near Aachen and close to the Belgian border. He studied at “an impressive array of universities” in Munich, Marburg, Berlin, and Bonn, graduating in medicine from the University of Bonn in 1890.1 He worked for four years as a pathologist in Giessen, then briefly also as a pathologist in Cologne, before undertaking in 1897 formal surgical training in Leipzig under the renowned Friedrich Trendelenburg.

After completing his surgical training in 1899, Wilms worked in Leipzig until 1907, when he became chief of a surgical service in Basel, Switzerland. In 1910, he reached the peak of his career by being called to the chair of surgery at the University of Heidelberg. He was described as diligent and highly intelligent, possessing an exceptional working capacity, as well as being a dexterous surgeon.

Wilms was interested in the origin of tumor cells and their development in the embryo. He had a particular interest in the surgical pathology of the kidney, bladder, and urogenital tract. In 1899, he wrote a paper titled “On mixed tumors of the kidney,” in which he described the tumor that still bears his name and typically affects children. It comprises a mixture of different tissues, such as immature kidney, muscle, and fat cells. He proposed that these tumors arose from embryonic kidney cells that had failed to differentiate during their development, a revolutionary concept at the time.

To this day, the Wilms tumor remains one of the most common solid tumors of children. Treatment by surgery, chemotherapy, and radiation has greatly improved its prognosis, and the overall five-year survival rate is now over ninety percent.

In May 1918, Wilms operated to save the life of a French prisoner of war who was suffocating from laryngeal swelling due to diphtheria. Wilms caught the disease in its most severe septic form and died a few days later. He was only fifty-one years old, at the height of a distinguished career. The French officer survived.

Paul Grawitz. Biographisches Lexikon hervorragender Ärzte des neunzehnten Jahrhunderts. Berlin, Wien, 1901, Sp. 628. Via Wikimedia.

Paul Albert Grawitz (1850–1932) was born in the eastern part of Germany, in Zerrin, once part of Prussia but now of Poland. He grew up on the farm of his father, who expected him to follow in his profession, but he decided to study medicine—first at Halle and then at the University of Berlin. After graduating in 1874, he worked as an assistant to Rudolf Virchow until 1886.1

In that year, Grawitz visited New York and was offered a position at the newly founded Carnegie Institute. Instead, he accepted the position of senior lecturer at the University of Greifswald on the Baltic Sea. A year later, the incumbent department chief died, and Grawitz was appointed as chair of pathological anatomy and director of the pathology institute, positions he held until his retirement in 1921. He was popular with the students despite his sarcastic sense of humor, published papers on many aspects of pathology, wrote several textbooks, and assembled a collection of 7,000 specimens for which he is remembered to this day.

In 1883, Gravitz wrote a much-quoted paper on the origin of certain kidney tumors called “The So-called-called Lipomas of the Kidney.”1 In this paper, he described a group of small, round, and pea-shaped tumors located generally at the periphery of the kidney, some bulging under the renal capsule. He concluded that these structures were not lipomas but consisted of adrenal gland tissue that somehow had found its way into the kidney. They became known as hypernephromas, and in time, all malignant tumors of the kidney, regardless of their size, were called hypernephromas or Grawitz tumors.2

Both appellations are utterly misleading, and it was suggested long ago that they should be eliminated.2 The malignant tumors are now simply called renal cancers, and survival rates depend at least in part on the stage when they are diagnosed and range from fifteen to ninety percent.


  1. WhoNamedIt? A dictionary of medical eponyms: “Max Wilms,” https://www.whonamedit.com/doctor.cfm/2109.html; “Paul Albert Grawitz,” https://www.whonamedit.com/doctor.cfm/3177.html.
  2. McCormick, William, and Cleland Blake. “Some notes on Paul Grawitz and his tumor.” Cancer 11.5 (1958): i-iii.

GEORGE DUNEA, MD, Editor-in-Chief

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