Wilms Tumor Flashcards
Wilms tumor is the commonest primary renal tumor of childhood T/F?
True
Age ranges for wilms tumor?
1-5 years
Peak age- between 3-4 years
Median age of presentation for unilateral and bilateral respectively?
Unilateral- 3yrs , 6 months
Bilateral- 2 years , 6 months
Sporadic: familial ratio
99% : 1 %
Symptoms of wilms tumor?
Hematuria
Weight loss
Obstipation
Diarrhea
Urinary Tract Infection
Previous trauma
Nausea
Abdominal pain
Signs of Wilms tumor?
Palpable mass in abdomen( flank mass which doesn’t cross the midline.
Hypertension due to hyper reninemia
What congenital anomalies are associated with wilms tumor?
- WAGR syndrome/ 11p deletion syndrome: Wilms tumor, Aniridia, Genitourinary anomalies and Mental Retardation.
- Denys- drash syndrome- Wilms tumor, early renal failure with mesangial sclerosis and pseudo hermaphroditism.
- Beckwith- wiedemann syndrome-
What are the associated paraneoplastic syndromes
Thrombocytosis
Bleeding diathesis due to presence of acquired von Willebrand disease.
Hypertension
Erythropoietin increased: males , older age and low clinical stage
What are the local patterns of spread?
Renal sinus or ureter
Renal vein into IVc and rarely, right atrium.
Regional lymph node involvement
Hematogenous spread patterns
Lungs- 80%
Liver- 15%
Rarely bone, bone marrow or brain
WT stage I
Confined to kidney, intact capsule
WT stage II
One kidney with breeched capsule
WT stage III
Residual tumor( when biopsy is done)
WT stage IV
Metastatic disease
WT stage V
Bilateral disease
Stage each kidney separately
