Oncology

Question 1

What is Nephroblastoma also know as?

Answer 1

Wilm’s tumour

Question 2

Which genetic and over-growth syndromes leave children at an increased risk of developing a nephroblastoma?

Answer 2

WAGR (Wilm’s tumour, Aniridia, Genitourinary malformations, and Retardation), Denys-Drash and Beckwith-Wiedemann

Question 3

Describe how a child with a nephroblastoma might present.

Answer 3

History may be only of an abdominal mass found incidentally or noted by parents during bathing or dressing in an otherwise well child. Children may also present with abdominal swelling, abdominal pain, fever or haematuria

Question 4

Describe the examination findings that might occur in a child with a nephroblastoma.

Answer 4

Examination is likely to reveal abdominal distension with unilateral or bilateral palpable renal masses. Hypertension may be noted. Rarely, in cases of advanced disease, signs of compression of other intraabdominal structures may be noted.

Question 5

What might be noted on the urine dip of a child with a nephroblastoma?

Answer 5

Haematuria

Question 6

What imaging is required for definitive diagnosis of a nephroblastoma?

Answer 6

Biopsy

Question 7

Describe the long term management of a child with a nephroblastoma.

Answer 7

Stage 1 and 2 tumours may be treated solely with surgery. There is no additional benefit to giving chemotherapy which has additional risks later in life.

Question 8

Where do Wilms tumours most commonly metastasise to?

Answer 8

Lung