Tag: Wilm’s Tumour

Wilm’s Tumour

Wilms tumour

Q. 1

Which among the following is the common presentation of Wilms tumour?

 A

Haematuria

 B

Mass in abdomen

 C

Pain

 D

Fever

Q. 1

Which among the following is the common presentation of Wilms tumour?

 A

Haematuria

 B

Mass in abdomen

 C

Pain

 D

Fever

Ans. B

Explanation:

Most children with Wilms tumor present with increasing size of the abdomen or an asymptomatic abdominal mass (83%) incidentally discovered by a parent and/or health care provider. 

 
Other clinical features,
  • Fever (23%)
  • Hematuria (21%)
  • Hypertension (25%)
  • Genitourinary malformations (6%)
  • Aniridia
  • Hemihypertrophy
Ref: Graham D.K., Quinones R.R., Keating A.K., Maloney K., Foreman N.K., Giller R.H., Greffe B.S. (2012). Chapter 31. Neoplastic Disease. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.

Q. 2

Which among the following is the least common symptom of Wilms tumour?

 A

Haematuria

 B

Mass abdomen

 C

Pain

 D

Fever

Q. 2

Which among the following is the least common symptom of Wilms tumour?

 A

Haematuria

 B

Mass abdomen

 C

Pain

 D

Fever

Ans. D

Explanation:

After neuroblastoma, Wilms tumor is the second most common abdominal tumor in children.

Symptoms consist of abdominal enlargement in 60%; pain in 20%; hematuria in 15%; malaise, weakness, anorexia, and weight loss in 10%; and fever in 3%. Hypertension is noted in over half of patients.
 
Ref: Albanese C.T., Sylvester K.G. (2010). Chapter 43. Pediatric Surgery. In G.M. Doherty (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.

Q. 3

Most important prognostic factor of wilms tumour –

 A

Histopathology

 B

Ploidy of cells

 C

Age < 1 yr

 D

Mutation, of clp gene

Q. 3

Most important prognostic factor of wilms tumour –

 A

Histopathology

 B

Ploidy of cells

 C

Age < 1 yr

 D

Mutation, of clp gene

Ans. A

Explanation:

Ans. is ‘a’ i.e., Histopathology

o Anaplastic nuclear change is the only criterion of “unfavourable” histology in Wilm’s tumor and all Wilm’s tumor lacking this feature are designated as having “favourable histology”.

o Anaplastic nuclear change reflects extreme polypoidy & is usually apparent under low magnification.

“Anaplastic histology remains a critical determinant of adverse prognosis. Even anaplasia restricted to kidney

confers an increased risk of recurrence & death, underscoring the need for correctly identifying this histologic features.”


Q. 4

The ideal timing of radiotherapy for Wilms Tumour after surgery is:

 A

Within 10 days

 B

Within 2 weeks

 C

Within 3 weeks

 D

Any time after surgery

Q. 4

The ideal timing of radiotherapy for Wilms Tumour after surgery is:

 A

Within 10 days

 B

Within 2 weeks

 C

Within 3 weeks

 D

Any time after surgery

Ans. A

Explanation:

A i.e. With in 10 days 

The postoperative radiotherapy in Willm’s tumor is started within 10 days of surgery. Delay in starting RT beyond 10 days leads to tumor cell repopulation and increase in relapse rate.

Indication of RT in Willim’s tumor are:

1.Stage II, III, IV with unfavourable histology (UH)

2. Stage III & IV with favourable histology (FH)

3.Metastatic disease

4. Clear cell sarcoma of kidney in all stages.

Quiz In Between



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

Module Below Start Quiz

Malcare WordPress Security