Wilms'
Tumor
W:ms tuyno9 is the most c0m mon type of
in ehildn. ilms' tumo oà ngpho ilostbona
nal eanocH necpla:m
15 a highly maligmont
enbngonal itph ator Max
kidncys. It is named
a#eeting ore on beth one of the fin!
doetoy ho twnote
Wis, a Grerman
aboud the diseay in 18 90.
madiaal astielos
ephoblastoma, is
tumoy , also hoon ay
kuoTn
Wilms' aeets
kidcy caneen that primaviy
a ype of
children.
Incidancai neoplasn in childan
the filth nost eonmon f
IA is malignaneies. g0 %
6'5% o ehildhood befovae 5 yeacs f
afeting dovelop wibns' tumo
ehilduv
Most comnmonly seen in oung childan with tho
"Ag-
avevage aqe bimg about 3-4 yeasg.
" Grander- Gints beas a slighty higher wisk of Wi ms
tumo
eo mpaned to bgys.
histomy- About 17.-a% of childae boh
Family or moe
Willmy tumor have one
polotives uoilh the an 0 .
1
"Condain geetie yndxome, - WA GR
yndrome
(Wilms' Eumor,
Aiidia, beni touinavy vaot abnonmalities
Mavdal Retand ation
Denys- Dpash syndome nd Fasien yndone
-Beckit h- Wiedemann syndrome
.Re«tain biwth difeols - Aninidi a(eomplele pastial
Lack of the ivis oa the eyes),
CoypBovohidism and Hypospadias.
. Gra netie- WTI gene Ioeaized at onomo50e 11p13
" Unknown
a Polhophysoloqyi siee befovae it
apidly inoeaes in
Wims tumor
is dagno sed.Tt dovelops in exal paenchy pma ix
loeation, The entie enal
the cntsal or polar tumor Laavng cn
pavenchy ma is eet upied with lesionsau
eomprsed nopmal tissue,
Tho
amim ande nevotie. The turop
yascular , 4oft, golalinous
mass guACUndod bu
appeas as a
pseudooapsude of oonneefe tiss uee whieh
the kidney ond tumo, he ymewhane
3epar ates, and ean
Ihe dumo is vey thin
zonpudating
be torn.
u cunieal Foatuw
AqympBomatie
large abdominal mass
Hevnatwia
typonlension
yAbdoyninal pain
D fevex
V
Avopex ia and vomiting
Arenia , 2hvombaoylosis nillbrand facton
2hequined deficieney of Von
aynd faoto VI| .
Pobyoythemia,.
Stoging _oB Wilms' Tumon:
Qainical
Aocopding to chiidacx's OneolgH Gouup ttaaing
yotem
T - h tumor was coined ithin one
kidoey and was eroised eomplatey yswgo
Aboud 0 45% of all Wins tumons ae stage T.,
stage T - The tumo has growx beyond the kidney
invading ether into naby fatty Eissue on into
he kidny , but it ear
blocd yessels, in o nuax tho
h wemeved ocmpletely by surgog. Aboxd 202 ofd
be
Limited ta
Wilns tonors oxLied to stage 1 .
" Stage SIN- Spwad to Lymph nodos in the abdonen
or polvis. Deposits of tumo (lwmo implants) asu
of the abdominal
ide ntified aloyg the inneg Lining'90.-25% of all
spaee after hi sugoy. About
Wilms tumops ae stafe .
Tumon spead thnough the blod to
"Stoge IV - Bvoe the kidruys `such as the lungs
iven, bnain or bones , on to Lymph nodes fan away
10 % of all Wilms' tumong
foom the kidngys . About
Bilateral kidnay involve mand takes place.
" stage - a stoqe
About B% of all Wilyns tuMOws
o Diognosis :
"Abdominoal X-ay Sh ouws soft tissue opacity in
the site of kidrey
"Ultvasoncqaphy and Doplor - Tadandify the
nent of contaaHal
ovigin ,involye
eT sean Tdntifies pulmoaty medastasi'ó.
"Chust X- pay- Tdentihies pubnonay metasBais
adjaee nt
" eTsean - Tdndfie, tumo eronsion to
-
ytuetwes,
. Tma venous ryclognaphyy -- Shows disBowtion o oalyes
by a nas within the kidncy .
For eonfmation hetome
"Fint needle eytology- ohoymotheaPy
10 ahildan with Widms tumon
Overall, ahont 9 to
,low stage and low tumo
ae ewed. Young agepnga osBie ia faotoe. The main
weight avu favo nal don Wilms umon axe sgery,
modaities of tneatment therapy . Most childen
and yadiation
ehemo theapy of tnealmond.
one
will get move than phnectomy most of
Radical ne is done in
the c S .
eo mmony wsed ehemothra
"Chemotheapy- The most
-Ry drugs attimomyciv D(Aat dactinoycin)
tuios erth unfavo nabd histolo
and vineçstive. Tn CAdziamyein) and
suek as doyomubicix
-44 daugs be Preopenative
sed.
ayelophos phamide may adso si2e of the
indieated to dininish he
aremothIapy is ated woith
T tuoops ae tne
Aumor. Gtage I ad postopexatively.
D and incoistine
aotino nye is wSuay wed
uualy tor move advancd
"Radiothetopy - Tt
tumors(stage M,i and )and for sone
Wilms' unfavoable istolagu.
eolier stage tumons with
Exieval boa ynadiation theapy is given 5days
fore a couple of oecks . Abdominal rudiatioy
oeck pubnonaey nadiation
is given in sBoge n
11N lumos and
given Bor pulmonay modasasi s5. Fop aduon ed
is
6
vineristing,
tunor ecmbination of ehomotheapy o abdominal
actimony cin D and adsia yi ehoie.
ane tyeat ment o
padiatio, ate
abdominal distondion
7 ATnspet fon ad
abdominal pain,fever , anone xia and
DwAsses3 fon
tor
VoYmting
Nuxóing Diagnosis
yPain elated to abdominal mass.
(pacndal) waaled to oul oome of suogerey
ynelated sugieal intene nlion
IRisk fop infection relatod to presena
/ Bisk foe defieient flud volume
of single kidrey olten Sungey.
nelatad to eao of the child
Defiient knosledge
NusingGoali
The ohild ill -
Re main oee drom pain in abdomen
NExhibit r0 of ivedeetion
Maidain adequade fluid volug.
)
The paert, ill patieipde n tho eass of
tho ehild.
o Pve-opesative Cooe - net to palpate the abdomon
WEplain the pands aan uptwe.
of theie dild as it
polpade thobdonen ' ngast
lae a sign 'Do mot
the bed side od the ohild.
Bepse the elidd ard fonily
7 oqe cgpropriate erplanatin!
rMoniton vital igrs, negulavty:
emot ionàl supports to the
p Provide their coneÝnn
expioess
n Allow the pasends to
and quemies equdrg akild'sehemotherapy
prgnois.
Rrepese for the side efeets of
and nadiotherapy
Postoperative Cae
IMonutop the ehild for I actinity, bowel sounds,
sbot stool pooduction, signs of infection and
Aemorhage
7 MonitoY vilal signs 9-4
Montor uive output don kidoey fenetion.
y I! NG tube is plaad No oltpud sholuld be
uaswud oveny 4 hooe.
Adrinisler veplo vent iduid with potasun
qouknie eontens aoe polasikn yoich.
) hdministor ad atibiot ies as ppesemibed
Admiistor ohemothapy drgs yia lavge
scofl tissue bins.
VeLy as they a ust
fe side eleds of demnothenopy
Movutep
ad adicthenapy
tumo is a ehildhcod
wilms
At last we kmow that ean be treated with
aneth on od kidney and
chematheapy nadiabon
ean be prbymed according
thsapy and siegoy
adanad of the tamoe.
to the stagimg on whiah
Thedysduwnotion oa kidgy oeues be eated
wine odput and i can
bads to ss im
tumcdylasis avd peaine peitoneal dialysi s
s in
wnth tahon of ahit
which speinl eae to be
<peoalized nuse.
