kidney nephroblastoma ( Wilms' tumor) in children - Causes, Symptoms and Treatment .MF .
Wilms' tumor or nephroblastoma - a malignancy occurring from fetal kidney tissue.The name of the tumor was in honor of the famous German surgeon Max Wilms, who first identified the disease in a child.As it turned out later, nephroblastoma can occur only in children, mostly under the age of 5 years, as it is they have a large number of fetal cells in the kidney tissues.
exact causes of Wilms tumor to date is not set.Some scholars suggest that the predisposition to the disease can be transmitted by inheritance, as the majority of children with this disorder have congenital malformations.There is active research to identify the causes nephroblastoma and other embryonic tumors.The research process included the best world experts in the field of medicine, genetics and embryology.
Symptoms nephroblastoma in children
In most cases, their Wilms tumor is asymptomatic.In this situation, it is most often detected in the form of parents hillocky tight formation in the child's abdomen.
Another symptom that makes it possible to detect the presence of Wilms' tumor is a gross hematuria (blood in the urine).Blood in the urine, as a rule, arises when the inner membrane collapse glomerular capsule.At the same time, the circulatory system of the kidneys connected to her pelvis, which is accompanied by bleeding into the cavity of the latter.
nonspecific symptoms that may accompany nephroblastoma, is a fever, weight loss, gastrointestinal disorders, and high blood pressure.These symptoms may be due to germination of tumor adjacent tissues or through violations of renal function.
If you have a child of at least one of the above symptoms and signs, it is necessary to take on the consultation to the urologist and oncologist.These experts joined forces to be able to set the correct diagnosis and adequate treatment.
Complete blood count with Wilms tumor is characterized by a progressive decrease in the number of red blood cells.The mechanism of development of anemia in this pathology as many as three.Firstly, malignancy, regardless of the location, followed by anemic syndrome.Secondly, due to impaired renal function decreased excretion of erythropoietin, which affects the production of red blood cells by the bone marrow.And the last link in the development of anemia is considered when nephroblastoma kidney bleeding that develops due to the aforementioned reasons.
Urinalysis with nephroblastoma characterized by the presence, in large numbers, renal epithelium and erythrocytes.Furthermore, the decay of tumors may increase the amount of protein in the urine sample, and during joining of infection - bacteria and leukocytes.
To verify the diagnosis using various imaging techniques.The most expensive and one of the most reliable considered ultrasound of the kidneys.On US marked a circular formation of increased echogenicity, located in the retroperitoneal space.
excretory urography in the early stages of the disease indicates a deformation pyelocaliceal kidney system.In the later stages of the disease indicated a complete lack of allocation of contrast agent kidney infection.
angiography of the body can be used for differential diagnosis of nephroblastoma and renal cyst.It involves the intravenous administration of contrast medium, followed by X-rays.As a rule, Wilms tumor observed increased blood flow to tumors, while cyst may have no arterial vessels.
Wilms' tumor on an x-ray
Computed tomography is the best imaging technique kidney.In conducting this study, it is possible not only to identify the tumor, but also accurately determine its size and location location.
final step in verification of malignant kidney tumors diagnosis is considered fine needle aspiration biopsy.Under the control of the device is performed ultrasound puncture the skin and soft tissues in the lumbar region, followed by taking a small section of tissue neoplasms.Under the electron microscope is performed histological study, during which, as a rule, identify atypical cells of embryonic origin.
Also, in order to detect distant metastases, it is necessary to carry out X-ray examination of the chest and osteostsitnigrafiyu.The first makes it possible to determine the presence of distant metastases in the lungs, in the second - in the bone.
Treatment nephroblastoma in children
as the main method of treatment of Wilms' tumor using surgery, the amount of which depends on the size of tumors and the spread.If the early stages can be dispensed only by simply removing the tumor, in the later stages of disease used nephrectomy with regional lymph node dissection.Surgical intervention should be applied as soon as possible after the detection of tumors.If such an abnormality is present in the newborn, it is to be operated during the first 14 days of his life.
In addition to surgery and chemotherapy can be used kilocuritherapy.The aim of these treatments is to prevent recurrence of the disease or reduce the size of the tumor before surgery.
worth noting that Wilms' tumor - is one of the few diseases that are highly amenable to surgical treatment.According to different statistical studies, the number of cured children with Wilms' tumor is 90 percent.
Treatment folk remedies
As a rule, patients with malignancies is not prohibited to use the traditional methods of treatment, as conventional medicine can not reliably guarantee a positive outcome.With Wilms' tumor is somewhat different situation.Since it in 70-90 percent of cases can be cured, folk treatments may only delay a good time for the start of surgical and conservative treatment.
Feeding habits and lifestyle
Unfortunately, patients with Wilms tumor should follow the recommendations for life, according to the table for 7 dietary Pevzner.They need to limit the amount of fat in the diet, salty, sour and fried food.This is necessary in order to reduce the load on a single diuretic healthy kidney.
rehabilitation after illness
As a rule, a few weeks after surgery patients received courses of physical therapy, during which he held various procedures and apparatus UVM darsonvalization.Good results observed after a spa treatment in Saki and Morshyn, where patients with kidney disease have developed special schemes bolneoterapii, mineral and mud treatments.
Complications Wilms tumor
very first complication that develops after the development of Wilms' tumor is hypertension.The mechanism of its development is no different from other development mechanism of renal hypertension.The increased production of renin, which is very strong vasospastic agent leads to a narrowing of the lumen of blood vessels and increased blood pressure.
Another feared complication is considered nephroblastoma kidney bleeding that develops as a result of violation of the consistency of the membrane in the glomerular capsule.Thus, bleeding occurs in the cavity of the renal pelvis, which is accompanied by a large number of blood clots in the blood and urine.Sudden loss of large amounts of blood can result in a fall in blood pressure and collapse, which is manifested by loss of consciousness.Long-term complications of renal bleeding should be considered as anemia, which has posthemorrhagic character.
so-called classical complications of malignancy should be considered as regional and distant metastases, which occur in the third and fourth stages of the cancer process.The most commonly observed with Wilms tumor metastasis to the lungs, which is manifested by pain in the chest, shortness of breath and bloody sputum release.
addition, complications of Wilms' tumor can be considered joining secondary infection and kidney stones.As a rule, nephrolithiasis with nephroblastoma occurs much harder than in apparently healthy kidney.
Wilms Tumor Prevention
Since in many cases, nephroblastoma is a congenital disease of cancer, its prevention should be carried out before the baby is born.It lies in the prevention of prenatal infection, which can disrupt the normal development of the fetus, in the rejection of alcohol and smoking during pregnancy, as well as a healthy dietary nutrition in child-bearing.
In addition, it is necessary to reduce to a minimum during pregnancy, traumatic injuries, and the harmful effects of environmental factors.All drugs that are used during pregnancy, the doctor should be checked for the absence of their teratogenic effect.
Postnatal prophylaxis nephroblastoma is the treatment and prevention of inflammatory diseases of the kidneys and the leveling influence of harmful environmental factors.
prognosis of nephroblastoma
As already mentioned, Wilms' tumor is one of the most favorable in terms of the treatment of malignant neoplasms, both kidneys, and other organs.About 8 out of ten children who completed the full course of treatment of this disease, for life never remember him.Of course, when treatment was started in the third or fourth stage when distant metastases are already available, the survival rate is much lower.
Ed.urologist Astashin EE