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Wilms tumor Diagnosis, Treatment
Wilms tumor Diagnosis, Treatment
Wilms' tumor - a fetal renal mesoblastic nephroma. It occurs mainly in childhood and is often combined with malformations of other organs and systems. The tumor as a node can be detected in any part of the kidney, rapidly growing and has a greater tendency to metastasize, what happens when you engage in the process of tumor vascular buds, which happens dissemination.
Etiology.
Wilms' tumor is a consequence of disruption of the normal embryonic development of tissues, which leads to the formation of a tumor and to the emergence of other anomalies.
Clinic.
Just as in the case of kidney cancer, any symptoms in the early stages may be absent. Typically, there are vague abdominal pain, may be found a tumor in the abdomen during the inspection and palpation (palpation) of the child. There is a weakness, malaise, loss of appetite, pale skin (due to anemia), fever without cause, may increase blood pressure. In the later stages there are persistent pain, ascites (big belly due to the accumulation of fluid in it because of the kinked inferior vena cava), swelling of extremities, varicocele (varicose veins of the spermatic cord).
The tumor spreads rapidly. First, in the next few lymph nodes, then to the lungs, liver and other organs.
Diagnosis of Wilms' tumor is based on collecting and analyzing the following data: Clinical data. There is a growing pattern of veins abdomen, ascites (accumulation of fluid in the abdominal cavity), asymmetric stomach, varicocele (testicular varicose veins). The tumor often enough and is easily detected by palpation, not only professional, but also parents, and it usually leads to seek medical advice. These medical imaging. They are:
Ultrasound
X-ray computed tomography
magnetic resonance imaging
renal scintigraphy
radiography
excretory urography
renal angiography.
These laboratory diagnosis of blood and urine. Identify the red blood cell, proteinuria, leukocyturia, increased erythrocyte sedimentation rate, etc.
Treatment.
Best results are obtained by a combination of operational, radiation and chemotherapy techniques.
Surgical treatment is usually limited to removal of the damaged kidney, as well as single metastatic tumors in other organs in their identification.
Radiation therapy is usually performed after surgical intervention, but may be carried out and the two courses - before and after surgery. In case of impossibility of surgical radiotherapy is used alone or combined with chemotherapy.
Chemotherapy can also be used before and after surgery, as well as an independent method.
Prognosis depends on the degree of malignancy of the tumor stage (presence of metastases), age of the patient. The smaller the child's age, the better the prognosis of survival. Thus, in children under one year survival rate is 90%, while the survival rate after 5 years of less than 50%.
