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Introduction
kidneys.
In the 1950s and 1960s, most children with nephroblastoma had a very poor prognosis, but treatment for the cancer has advanced significantly in the intervening decades.
Cont.
It's thought to come from very specialised cells in the embryo known as metanephric blastema.
These cells are involved in the development of the child's kidneys while they're in the womb.
Definition
A Wilms tumor is a
Causes
In most children the causes of Wilms' tumour are unknown. In 1 in 100 people with Wilms' tumour, another family member will also have Wilms' tumour.
100,000 people.
Most children with this cancer are diagnosed between three and four years of age. Children commonly have tumors in one kidney only; in around 6% of cases tumors grow in both kidneys.
Signs and symptoms of neuroblastoma vary depending on what part of the body is affected.
Cont
Neuroblastoma in the
abdomen :
Neuroblastoma in the
chest : Wheezing Chest pain Changes to the eyes,
Abdominal pain A mass under the skin that isn't tender when touched
including drooping
eyelids and unequal
pupil size
Lumps of tissue under the skin Eyeballs that seem to protrude from the sockets (proptosis)
Dark circles, similar to bruises, around the eyes Back pain Fever Unexplained weight loss Bone pain
Blood tests:-
Radiology studies
Biopsy
Treatment
If there are tumors in both kidneys, a piece of the tumor will be removed. After the surgery, the child is given some chemotherapy drugs like Dactinomycin (trade name Cosmegen).
Cont
Surgery
Stage
Stage I
Tumor is limited to the kidney and is completely excised. The surface of the renal capsule is intact.
Treatment: Nephrectomy +/- 18 weeks of chemotherapy depending on age of patient and weight of tumor.
Stage II
Tumor involvement of the blood vessels of the renal sinus and/or outside the renal parenchyma.
weeks of chemotherapy
Stage III
Stage IV
Stage IV Wilms' tumor is defined as the presence of hematogenous metastases (lung, liver, bone, or brain), or lymph node metastases outside the abdomenopelvic region.
Treatment: Nephrectomy + abdominal radiation + 24 weeks of chemotherapy + radiation of metastatic site as appropriate
Stage V
Children with high-risk neuroblastoma may receive a transplant using their own blood stem cells (autologous stem cell transplant). The bone marrow produces stem cells, which mature and develop into the red and white cells and platelets that make up the blood.
Child undergoes a procedure that filters and collects stem cells from
his or her blood. Then high doses of chemotherapy are used to kill any remaining cancer cells in child's body. child's stem cells are then injected into child's body, where they can form new, healthy blood cells.
Side effects
hair loss,
bruising and bleeding, tiredness, diarrhoea and an increased risk of infection.
Nursing Management
Prognosis
Effective diagnosis, staging, and multimodality therapy has dramatically reduced the morbidity and mortality in children with nephroblastoma