Wilm’s Tumour

WILM’S TUMOUR


WILM’S TUMOUR (NEPHROBLASTOMA)

  • It is a malignant tumour of kidney which is seen in children
  • Tumour is composed of epithelial and mesothelial elements (bone, cartilage, muscle etc) so called as nephroblastoma (immature embryonic tissue)
  • Tumour arise in one of the poles of kidney.

Clinical features-

  • Common in female children (2-4 years)
  • Mass in the abdomen.
  • Abdominal distension due to enlarged kidney
  • Rarely, Wilm’s tumour is bilateral
  • Hematuria
  • Low grade fever
  • Rapid deteriotion of health is characteristic feature.

Spread of infection-

  1. Direct infiltration
  2. Lymphatic spread
  3. Hematogenous spread

Investigations-

  • Abdominal USG detects solid tumour in kidney
  • CT scan to know extent and spread of infection
  • IVP- study of distortion of calyces
  • FNAC for comfirmation

Treatment-

  1. For tumour confined to renal capsule-
  • Radical nephrectomy followed by chemotherapy with antinomycin D and Vincristine

2. For tumour beyond renal capsule

  • Nephrectomy followed by local radiotherapy and chemotherapy
  • The ideal timing of radiotherapy for Wilms Tumour after surgery is within 10days.

3. Bilateral Wilm’s tumour-

  • Radical nephrectomy on larger side of tumour and partial nephrectomy on side of tumour.

Exam Important

Clinical features-

  • Common in female children (2-4 years)
  • Mass in the abdomen.
  • Abdominal distension due to enlarged kidney
  • Rarely, Wilm’s tumour is bilateral
  • Hematuria
  • Low grade fever
  • Rapid deteriotion of health is characteristic feature.

Treatment-

  1. For tumour confined to renal capsule-
  • Radical nephrectomy followed by chemotherapy with antinomycin D and Vincristine

2. For tumour beyond renal capsule

  • Nephrectomy followed by local radiotherapy and chemotherapy
  • The ideal timing of radiotherapy for Wilms Tumour after surgery is within 10days.

3. Bilateral Wilm’s tumour-

  • Radical nephrectomy on larger side of tumour and partial nephrectomy on side of tumour.
Don’t Forget to Solve all the previous Year Question asked on WILM’S TUMOUR

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