WILM'S TUMOR (Congenital Nephroblastoma) |
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WILM'S TUMOR (Congenital Nephroblastoma)
DESCRIPTIONWilm's tumor is a malignant mixed tumor (one that contains several cell types) of the kidney that occurs primarily in children. Only one kidney is involved in 90% of these tumors. Wilm's tumor affects children under age 7, with a peak incidence between ages 3 and 4. Appropriate health care includes: physician's monitoring of general condition, medications, and treatment; surgery to remove the child's affected kidney and adjacent tissue, if the cancer has spread; hospitalization for radiation treatment and anti-cancer drugs.
SIGNS & SYMPTOMS
Enlarged abdomen (a large, firm, smooth tumor can be felt easily within the child's abdominal wall); high blood pressure; blood in the urine; abdominal pain (sometimes); repeated vomiting; fever; weight loss.
CAUSES
Unknown. It is probably congenital but dormant until it becomes active at some point before age 7.
RISK FACTORS
Genetic factors. It is most likely in children with other congenital abnormalities.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented at present.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as 24-hour urine studies.
X-rays of the child's abdomen, kidneys, and chest.
Special studies that may include:
-- Ultrasonography: A non-invasive technique that translates sound waves into images displayed on a screen and photographed (See Glossary).
-- CAT or CT Scan (computerized axial tomography): Non-invasive computerized X-ray images that show sections (or "slices") of an organ or region of the body clearly and precisely (See Glossary).
-- MRI (magnetic resonance imaging): A non-invasive (non-X-ray) computerized test that uses radio frequency energy and a powerful magnetic field to produce images with excellent detail (See Glossary).
-- Radionuclide Scan: A nuclear medicine procedure that uses radioactive isotopes injected into a patient. The isotope tracers are absorbed in various concentrations by targeted organs, which are then photographed (See Glossary).
POSSIBLE COMPLICATIONS
Kidney failure.
Tumor spread to the lungs, bones, liver, or brain if untreated.
Adverse reactions, including hair loss, from radiation treatment and anti-cancer drugs.
PROBABLE OUTCOME
With appropriate treatment, the outlook is better than for most malignant tumors in children. In most cases, Wilm's tumor is curable with surgery, radiation treatment, and anti-cancer drugs. If the tumor is detected before it spreads, the 5-year survival rate is 90%.
TREATMENT
HOME CAREFollow surgeon's instructions for postoperative care.
MEDICATION
Your doctor may prescribe:
Anti-cancer drugs.
Anti-nausea drugs.
Pain relievers.
Antibiotics, if infection occurs during anti-cancer drug treatment.
Stool softeners to prevent constipation following surgery.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions. The child may be as active as strength allows.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?After successful surgery and recuperation.
CALL YOUR DOCTOR IF
Your child has symptoms of Wilm's tumor.
The following occurs during treatment:
-- Vomiting, abdominal pain, or constipation.
-- Shortness of breath.
-- Swelling in the child's feet or ankles.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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