Wilms tumour
| A | Haematuria | |
| B |
Mass in abdomen |
|
| C |
Pain |
|
| D |
Fever |
Which among the following is the common presentation of Wilms tumour?
| A |
Haematuria |
|
| B |
Mass in abdomen |
|
| C |
Pain |
|
| D |
Fever |
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.
- Fever (23%)
- Hematuria (21%)
- Hypertension (25%)
- Genitourinary malformations (6%)
- Aniridia
- Hemihypertrophy
| A |
Haematuria |
|
| B |
Mass abdomen |
|
| C |
Pain |
|
| D |
Fever |
Most important prognostic factor of wilms tumour –
| A |
Histopathology |
|
| B |
Ploidy of cells |
|
| C |
Age < 1 yr |
|
| D |
Mutation, of clp gene |
Ans. is ‘a’ i.e., Histopathology
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”.
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.”
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 |
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.