renal embryonal tumor

Introduction

Introduction to renal embryonal tumor Renal embryonal tumor, also known as nephroblastoma or Wilm's tumor, is a common intra-abdominal tumor in young children. In various malignant tumors of young children, this disease accounts for about 1/4, most commonly seen in children under 3 years old, 3 to 5 The age-related morbidity rate is significantly reduced. It is rare after 5 years old, and adults are rare. There is no significant difference in the incidence rate between men and women. Most of them are on one side, and about 10% of both sides are concurrent. basic knowledge Sickness ratio: 20% to 25% Susceptible people: no specific population Mode of infection: non-infectious Complications: high blood pressure

Cause

Kidney embryo tumor etiology

Renal embryonal tumor is a malignant mixed tumor composed of epithelium and interstitial. It is often a large solid tumor with an outer envelope containing various tissues such as glands, nerves, muscles, light bones, fat, etc. The tumor grows extremely fast, highly malignant, and distant metastasis can occur in the early stage. The metastasis pathway is the same as renal cancer, and often metastasizes to the lungs, liver, and bones.

Prevention

Kidney embryo tumor prevention

Without special prevention, the long-term survival rate of renal embryonal tumor has been significantly improved under the combined application of surgery, radiotherapy and chemotherapy. For early patients, the five-year survival rate is above 90%, but for patients with simple surgery or late course of disease. Children, the five-year survival rate is very unsatisfactory, and the chance of recurrence after relapse in the five years after treatment is greatly reduced.

Complication

Renal embryonal tumor complications Complications

It can be transferred to the lungs, liver, bones, brain, etc. by blood.

Symptom

Renal embryonal tumor symptoms common symptoms nausea abdominal pain bloating

Asymptomatic masses are often found in family members and doctors during routine physical examination. Common symptoms are abdominal pain, bloating, anorexia, nausea and vomiting, fever, hematuria, etc. Common signs are abdominal masses. About 25% to 60% of patients have hypertension. It may be related to the increase of renin level. Tumor staging: NWTS staging is mainly based on surgical treatment and pathological manifestations. The most widely used method is NWTS3 staging. The tumor staging is:

Stage I: The tumor is confined to the kidney and can be completely resected; there is no rupture before or during the operation, and no tumor remains at the resection margin.

Stage II: The tumor has spread to the outside of the kidney and can be completely resected; there is a localized spread, such as the tumor has penetrated the renal capsule to reach the surrounding soft tissue; there is a tumor thrombus in the extrarenal blood vessel or has been infiltrated by the tumor; a biopsy has been performed. Or the tumor was found to escape during the operation, but only at the waist, and there was no obvious tumor remaining at the edge of the resection.

Stage III: Absence of non-blood-derived tumors in the abdomen, tumor metastasis by biopsy in the renal or para-aortic lymph nodes, extensive tumor infiltration in the peritoneal cavity, tumor implantation in the peritoneum, and residual tumors at the margin of resection The tumor was not completely removed due to infiltration of important tissues around it.

Stage IV: There are hematogenous metastases such as lung, liver, bone, brain and so on.

Examine

Renal embryonal tumor examination

The abdomen found in the abdomen of the child, which is obviously increased in a short period of time. Firstly, the renal embryo tumor should be considered. The surface of the abdominal mass should be flat and hard, B-ultrasound, CT scan can confirm the relationship between the tumor and the kidney and whether the mass is cystic or Reality, which is of great significance for the diagnosis of this disease, the abdominal plain film can be seen with the shadow of the tumor and the presence or absence of calcification, ossification, renal pelvis and renal pelvis can be seen or not, and the function of the contralateral kidney can be understood. In the differential diagnosis, it is mainly necessary to distinguish from congenital hydronephrosis. B-ultrasound and CT scan can confirm this lesion.

Diagnosis

Diagnosis and diagnosis of renal embryonal tumor

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

Differential diagnosis of abdominal mass in children includes hydronephrosis, renal cyst, renal neuroblastoma, mesoderm cell tumor and various rare sarcomas. B-ultrasound can identify hydronephrosis and renal cysts. Neuroblastoma originates from the adrenal gland or The paravertebral ganglia, pathology can be distinguished from Wilms tumors. X-ray examination has several characteristics when identifying neuroblastoma:

1 Wilms tumor is confined to one side of the abdomen, and neuroblastoma often crosses the midline.

2 Wilms tumor is an intrarenal tumor, and renal axis changes rarely occur. Neuroblastoma can make the kidneys shift outwards. In addition, renal neuroblastoma is more likely to metastasize. X-rays often show calcification, and neuroblastoma can also Tumor markers, such as vanillic acid, are produced. Mesenchymal renal cell tumors are benign hamartomas, which are difficult to differentiate from Wilms tumors before surgery. They often occur in the neonatal period, and pathology can be diagnosed after nephrectomy.

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